Skip to main content
SpringerLink
Log in

Infectious Complications in Infective Endocarditis

  • Chapter
  • First Online:
Infective Endocarditis

  • 1757 Accesses

Abstract

Endocarditis has protean systemic and cardiac manifestations. The infective vegetation mediates a destructive process which can involve the cardiac valves and/or perivalvular region. Valvular complications can vary from leaflet erosion or perforation to diverticulum formation, while perivalvular involvement includes abscess, perivalvular regurgitation, pseudoaneurysm and fistula. Transesophageal echocardiography is the preferred imaging tool in the diagnosis of both valvular and perivalvular complications. Prompt detection of these complications is crucial to the timing of surgery and the surgical approach.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hoen B, Duval X. Clinical practice. Infective endocarditis. N Engl J Med. 2013;368(15):1425–33.

    Article  CAS  PubMed  Google Scholar 

  2. Osler W. The principles and practice of medicine : designed for the use of practitioners and students of medicine. 14th ed. New York: Appletone; 1942.

    Google Scholar 

  3. Chan KL, Dumesnil JG, Cujec B, Sanfilippo AJ, Jue J, Turek MA, Robinson TI, Moher D. Investigators of the multicenter aspirin study in infective endocarditis a randomized trial of aspirin on the risk of embolic events in patients with infective endocarditis. J Am Coll Cardiol. 2003;42(5):775–80.

    Article  CAS  PubMed  Google Scholar 

  4. Kang N, Wan S, Ng CSH, Underwood MJ. Periannular extension of infective endocarditis. Ann Thorac Cardiovasc Surg. 2009;15(2):74–81.

    PubMed  Google Scholar 

  5. Keynan Y, Rubinstein E. Pathophysiology of infective endocarditis. Curr Infect Dis Rep. 2013;15:342–6.

    Article  PubMed  Google Scholar 

  6. McKinsey DS, Ratts TE Bisno AL. Underlying cardiac lesions in adults with infective endocarditis the changing spectrum. Am J Med. 1987;82(4):681–8.

    Article  CAS  PubMed  Google Scholar 

  7. Rohmann S, Erbel R, Darius H, et al. Prediction of rapid versus prolonged healing of infective endocarditis by monitoring vegetation size. JASE. 1991;4:465–74.

    CAS  Google Scholar 

  8. Buchbinder NA, Roberts WC. Left-sided valvular active infective endocarditis. A study of forty-five necopsy patients. Am J Med. 1972;53(1):20–4.

    Article  CAS  PubMed  Google Scholar 

  9. Lester SJ, Wilansky S. Endocarditis and associated complications. Crit Care Med. 2007;35(8 Suppl):S384–91.

    Article  PubMed  Google Scholar 

  10. Anguera I, Miro JM, Evangelista A, Cabell CH, San Roman JA, et al. Periannular complications in infective endocarditis involving native aortic valves. Am J Cardiol. 2006;98:1254–60.

    Article  PubMed  Google Scholar 

  11. Li J, Sexton D, Mick N, et al. Proposed modifications of the duke criteria for the diagnosis of infective endocarditis. Clin Inf Dis. 2000;30:633–8.

    Article  CAS  Google Scholar 

  12. Suty C, Celard M, Le Moing V, et al. Preeminence of staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis. 2012;54(9):1230–9.

    Article  Google Scholar 

  13. Hassine M, Boussada M, Tahar M, et al. Infective endocarditis complicated by heart failure: characteristics and prognosis. Arch Cardiovasc Dis Supp. 2015;7:44–57.

    Google Scholar 

  14. Chambers HF, Morris DL, Tauber MG, et al. Cocaine use and the risk for endocarditis in intravenous drug users. Ann Intern Med. 1987;106:833–6.

    Article  CAS  PubMed  Google Scholar 

  15. Moss R, Munt B. Injection drug use and right sided endocarditis. Heart. 2003;89:577–81.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Roberts WC, Buchbinder NA. Right-sided valvular infective endocarditis. A clinicopathologic study of twelve necropsy patients. Am J Med. 1972;53(1):7–19.

    Article  CAS  PubMed  Google Scholar 

  17. Graupner C, Vilacosta I, San Roman J, et al. Periannular extension of infective endocarditis. J Am Coll Cardiol. 2002;39(7):1204–11.

    Article  PubMed  Google Scholar 

  18. San Roman JA, Vilacosta I, Sarria C, et al. Clinical course, microbiologic profile, and diagnosis of periannular complications in prosthetic valve endocarditis. Am J Cardiol. 1999;83:1075–9.

    Article  CAS  PubMed  Google Scholar 

  19. Omani B, Shapiro S, Ginzton L, Robertson JM, Ward J, Nelson RJ, Bayer AS. Predictive risk factors for pericannular extension of native valve endocarditis. Clinical and echocardiographic analyses. Chest. 1989;96:1273–9.

    Article  Google Scholar 

  20. Chan K. Early clinical and long-term outcomes of patients with infective endocarditis complicated by perivalvular abscess. CMAJ. 2002;167(1):19–24.

    PubMed  PubMed Central  Google Scholar 

  21. Byrd BF, Shelton ME, Wilson BH, Schillig S. Infective perivalvular abscess of the aortic ring: echocardiographic features and clinical course. Am J Cardiol. 1990;66:102–5.

    Article  PubMed  Google Scholar 

  22. Aksoy O, Sexton DJ, Wang A, Pappas PA, Kourany W, Chu V, Fowler Jr VG, Woods CW, Engemann JJ, Corey GR, Harding T, Cabell CH. Early surgery in patients with infective endocarditis: a propensity score analysis. Clin Infect Dis. 2007;44(3):364–72.

    Article  PubMed  Google Scholar 

  23. Pongratz G, Pohlmann M, Gehling G, Bachmann K. Images in cardiovascular medicine. Pseudoaneurysm in the intervalvular mitral-aortic region after endocarditis and prosthetic aortic valve replacement. Circulation. 1997;96:3241–2.

    Article  CAS  PubMed  Google Scholar 

  24. Xie M, Yuman L, Tsung O, et al. Pseudoaneurysm of the mitral-aortic intervalvular fibrosa. Int J Cardiol. 2013;166:2–7.

    Article  PubMed  Google Scholar 

  25. Bansal RC, Moloney PM, Marsa RJ, Jacobson JG. Echocardiographic features of a mycotic aneurysm of the left ventricular outflow tract caused by perforation of mitral-aortic intervalvular fibrosa. Circulation. 1983;67:930–4.

    Article  CAS  PubMed  Google Scholar 

  26. Tiwari KK, Murzi M, Mariani M, Glauber M. Giant pseudo-aneurysm of the left ventricle outflow tract after aortic root replacement for extensive endocarditis. Eur J Cardiothorac Surg. 2009;36:399.

    Article  PubMed  Google Scholar 

  27. Anguera I, Miro J, Vilacosta I, et al. Aorto-cavitary fistulous tract formation in infective endocarditis: clinical and echocardiographic features of 76 cases and risk factors for mortality. Eur Heart. 2005;26:288–97.

    Article  Google Scholar 

  28. Krishna R, Casanova P, Larrauri-Reyes M, et al. Complete dehiscence and unseated prosthetic aortic valve causing severe aortic insufficiency: an unusual complication of prosthetic valve endocarditis. BMJ Case Rep. 2014; 206925.

    Google Scholar 

  29. Mullany CJ, Chua YL, Schaff HV, Steckelberg JM, Ilstrup DM, Orszulak TA, et al. Early and late survival after surgical treatment of culture-positive active endocarditis. Mayo Clin Proc. 1995;70:517–25.

    Article  CAS  PubMed  Google Scholar 

  30. Choussat R, Thomas D, Isnard R, Michel PL, Iung B, Hanania G, et al. Perivalvular abscesses associated with endocarditis: clinical features and prognostic factors of overall survival in a series of 233 cases. Eur Heart J. 1999;20:232–41.

    Article  CAS  PubMed  Google Scholar 

  31. Jault F, Gandjbakhch I, Chastre JC, Levasseur JP, Bors V, Gibert C, et al. Prosthetic valve endocarditis with ring abscesses: surgical management and long-term results. J Thorac Cardiovasc Surg. 1993;105:1106–13.

    CAS  PubMed  Google Scholar 

  32. d’Udekem Y, David TE, Feindel CM, Armstrong S, Sun Z. Long-term results of surgery for active infective endocarditis. Eur J Cardiothorac Surg. 1997;11:46–52.

    Article  PubMed  Google Scholar 

  33. Allan R, Hynes M, Burwash IG, Veinot JP, Chan KL. Coronary artery complications in infective endocarditis. Ann Thorac Surg. 2008;86(4):1381.

    Article  PubMed  Google Scholar 

  34. Parashara DK, Jacobs LE, Kotler MN, Yazdanfar S, Speilman SR, et al. Angina caused by systolic compression of the left coronary artery as a result of pseudoaneurysm of the mitral-aortic intervalvular fibrosa. Am Heart J. 1995;129:417–21.

    Article  CAS  PubMed  Google Scholar 

  35. Rozich JD, Edwards WD, Hanna RD, et al. Mechanical prosthetic valve associated strands: pathologic correlates to transesophageal echocardiography. J Am Soc Echocardiogr. 2003;16:97–100.

    Article  PubMed  Google Scholar 

  36. Shapiro SM, Young E, De Guzman S, et al. Transesophageal echocardiography in diagnosis of infective endocarditis. Chest. 1994;105:377–82.

    Article  CAS  PubMed  Google Scholar 

  37. Erbel R, Rohmann S, Drexler M, et al. Improved diagnostic value of echocardiography in patients with infective endocarditis by transoesophageal approach. A prospective study. Eur Heart J. 1988;9:43–53.

    CAS  PubMed  Google Scholar 

  38. Sochowski RA, Chan K-L. Implication of negative results on a monoplane transesophageal echocardiographic study in patients with suspected infective endocarditis. J Am Coll Cardiol. 1993;21:216–21.

    Article  CAS  PubMed  Google Scholar 

  39. Daniel WG, Mugge A, Martin RP, et al. Improvement in the diagnosis of abscess associated with endocarditis by transesophageal echocardiography. N Engl J Med. 1991;324:795–800.

    Article  CAS  PubMed  Google Scholar 

  40. Afridi I, Apostolidou MA, Saad RM, Zoghbi WA. Pseudoaneurysms of the mitral-aortic intervalvular fibrosa: dynamic characterization using transesophageal echocardiographic and doppler techniques. J Am Coll Cardiol. 1995;25:137–45.

    Article  CAS  PubMed  Google Scholar 

  41. Chan K, Cohen G, Sochowski R, Baird M. Complications of transesophageal echocardiography in ambulatory adult patients: analysis of 1500 consecutive patients. J Am Soc Echocardiogr. 1991;4:577–82.

    Article  CAS  PubMed  Google Scholar 

  42. Evangelista A, Gonzalez-Alujas M. Echocardiography in infective endocarditis. Heart. 2004;90:614–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Ellis S, Godstein J, Popp R. Detection of endocarditis-associated perivalvular abscesses by two-dimensional echocardiography. JACC. 1985;5(3):647–53.

    Article  CAS  PubMed  Google Scholar 

  44. Agirbasli M, Fadel B. Pseudoaneurysm of the mitral-aortic intervalvular fibrosa. Echocardiography. 1999;16(2):253–7.

    Article  PubMed  Google Scholar 

  45. Feuchtner G, Stolzmann P, Dichtl W, et al. Multislice computed tomography in infective endocarditis. J Am Coll Cardiol. 2009;53(5):436–44.

    Article  PubMed  Google Scholar 

  46. Nishimura R, Otto C, Bonow R, et al. AHA/ACC guidelines for the management of patients with valvular heart disease. Circulation. 2014;2014:129.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, The Health Sciences Centre, Memorial University, St. John’s, Newfoundland and Labrador, Canada

    Bradley Hayley MD

  2. Department of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada

    Kwan Leung Chan MD, FRCPC, FAHA, FACC

Authors
  1. Bradley Hayley MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kwan Leung Chan MD, FRCPC, FAHA, FACC
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kwan Leung Chan MD, FRCPC, FAHA, FACC .

Editor information

Editors and Affiliations

  1. Cardiology Department, HĂ´pital La Timone, Marseille, France

    Gilbert Habib

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Hayley, B., Leung Chan, K. (2016). Infectious Complications in Infective Endocarditis. In: Habib, G. (eds) Infective Endocarditis. Springer, Cham. https://doi.org/10.1007/978-3-319-32432-6_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-32432-6_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-32430-2

  • Online ISBN: 978-3-319-32432-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation