Outcomes of Prosthetic Valve Endocarditis Managed by a Multidisciplinary Endocarditis Team

Authors

• Bennett Collis, University of Kentucky College of Medicine
• Takaaki Kobayashi, Univ. of Kentucky Medical Center
• Evan Hall, University of Kentucky College of Medicine
• Talal Alnabelsi, University of Kentucky
• Chloe Cao, Univ. of S. Florida Coll. of Med.
• Meredith Johnson, Univ. of Kentucky Medical Center
• John Gurley, University of KentuckyFollow
• Hassan Reda, Univ. of Kentucky Medical Center
• Tessa London, Univ. of Kentucky Medical Center
• Erinn Ogburn, Univ. of Kentucky Medical Center
• Michael Sekela, University of KentuckyFollow
• Bobbi Jo Stoner, University of Kentucky
• Sami El-Dalati, University of KentuckyFollow

Abstract

Background: Prosthetic valve endocarditis (PVE) is a serious complication of valve replacement associated with significant morbidity and mortality. However, outcomes for medical vs surgical strategies remain incompletely characterized. Methods: We conducted a retrospective cohort study of adult patients with PVE, defined by modified Duke criteria, evaluated by a multidisciplinary endocarditis team at a tertiary-care centre between September 2021 and February 2024. Demographic, clinical, management, and outcome data were collected. Logistic regression analyses were performed to identify factors associated with in-hospital mortality. Results: Among 67 patients with PVE, 58.2% (n = 39) were managed medically, and 41.8% (n = 28) underwent surgical intervention during the index hospitalization. Baseline characteristics and comorbidities were similar across groups. The in-hospital mortality incidence was 7.7% in the medical cohort and 10.7% in the surgical cohort, and the incidence of 90-day mortality was 30.8% and 21.4%, respectively. Surgical patients had a longer median length of stay (28 days vs 15 days). Readmission and reinfection rates were comparable. Acute renal failure was the only independent predictor of in-hospital mortality on multivariable analysis (odds ratio, 9.61; 95% confidence interval, 1.19-77.67; P = 0.04). Medical management was not independently associated with increased in-hospital mortality (odds ratio, 0.97; 95% confidence interval, 0.14-6.68; P = 0.97). Conclusions: In this cohort of patients with PVE, individualized treatment guided by a multidisciplinary team was associated with favourable short-term outcomes. Medical therapy may be a safe alternative in selected patients without surgical indications. Early identification of acute renal dysfunction may assist in prognostication and inform management decisions.

Document Type

Article

Publication Date

2-1-2026

Notes/Citation Information

Publisher Copyright: © 2025 The Authors

Digital Object Identifier (DOI)

10.1016/j.cjco.2025.10.017

Archival?

Archival

Repository Citation

Collis, Bennett; Kobayashi, Takaaki; Hall, Evan; Alnabelsi, Talal; Cao, Chloe; Johnson, Meredith; Gurley, John; Reda, Hassan; London, Tessa; Ogburn, Erinn; Sekela, Michael; Stoner, Bobbi Jo; and El-Dalati, Sami, "Outcomes of Prosthetic Valve Endocarditis Managed by a Multidisciplinary Endocarditis Team" (2026). Radiology Faculty Publications. 47.
https://uknowledge.uky.edu/radiology_facpub/47