https://doi.org/10.4081/monaldi.2022.2251
Right-sided infective endocarditis and pulmonary embolism: a multicenter study
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The incidence of right-sided infective endocarditis (RSIE) is steadily increasing and it has been reported to be associated with high risk of embolic events (EE). Aim of our study was to identify the clinical characteristics of patients with RSIE complicated by PE. Indeed, the identification of patients at high risk of significant PE who will benefit from a more aggressive therapeutic strategy may improve the prognosis. From January 2015 to September 2020, 176 patients (Pts) in 6 centers were found to have definite RSIE complicated by PE. Advanced imaging for PE including computed tomography pulmonary angiography (CTPA) was performed in 28 pts (16%) who represent our study group (24 male, mean age 50.6 ±18.29 years). They all underwent transesophageal echocardiography (TEE), in 12 cases (43%) also three-dimensional (3D) TEE, and 27 patients (99%) had both TEE and transthoracic echocardiography (TTE). A total of 53 vegetations (V) were detected. In 18 pts (64%) two or more vegetations were found. Native tricuspid valve was the most frequently involved valve (38 V, 71.7%), followed by catheter (5 V, 9.4%), tricuspid valve prosthesis (4 V, 7.5%), chordae and papillary muscle (2 V, 3.8%) and one vegetation (9%) in each of the following: pulmonic valve, inferior vena cava, eustachian valve, and right atrium. The most common location for vegetations was the anterior leaflet of the tricuspid valve (19 V, 35.8 %) followed by the posterior leaflet (11 V, 20.8%). The most common vegetations morphology was raceme-like shaped (35.8%). Staphylococcus aureus (S. aureus) was the most common causative pathogen (14 pts, 50%). The incidence of PE was very high in patients with vegetation length above 1.5 cm (median 17.6±6.5 mm by TEE). Our results suggest that a routine CTPA should be advised in the presence of vegetations larger than 1.5 cm and with S. aureus infection. This behavior would identify patients at high risk of PE who will benefit from a more aggressive therapeutic strategy, leading to an improvement in the prognosis. Further prospective studies are required to better confirm our hypothesis.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Iqbal Akhtar Khan, Paola Pierucci, Nicolino Ambrosino, COPD patients’ pre-flight check: A narrative review , Monaldi Archives for Chest Disease: Vol. 92 No. 4 (2022)
- Diana Alexandra Gonçalves Pimenta, Renata Carvalho, Raquel Pereira, Rui Rolo, Lurdes Ferreira, Interstitial nephritis secondary to treatment with pembrolizumab, a rare complication in two patients with lung adenocarcinoma , Monaldi Archives for Chest Disease: Vol. 93 No. 2 (2023)
- Jaikrit Bhutani, Aditya Batra, Ashu Gupta, Anshul Gupta, Kunal Mahajan, Transient left ventricular dysfunction after therapeutic pericardiocentesis - Takotsubo cardiomyopathy or pericardial decompression syndrome , Monaldi Archives for Chest Disease: Vol. 92 No. 4 (2022)
- Devika Tayal, Prerna Jain, Mamta Bhardwaj, Amit Sharma, Diabetes mellitus in acute exacerbation of chronic obstructive pulmonary disease – the tip of the iceberg , Monaldi Archives for Chest Disease: Early Access
- Angelica Cersosimo, Mattia Di Pasquale, Gianmarco Arabia, Marco Metra, Enrico Vizzardi, COVID myocarditis: a review of the literature , Monaldi Archives for Chest Disease: Early Access
- Jaikrit Bhutani, Aditya Batra, Mridul Doomra, Kunal Mahajan, Hemiazygous continuation of inferior vena cava draining into the coronary sinus via persistent left superior vena cava: a rare anomaly , Monaldi Archives for Chest Disease: Vol. 93 No. 1 (2023)
- Amit Gupta, Aman Snehil, Sujeet Kumar, Roshan Chanchlani, Reyaz Ahmad, Keerti Swarnkar, Garima Goel, Bronchiectasis without lower respiratory symptoms in the presence of multisystem anomalies – a clinical clue to diagnose esophageal lung anomaly , Monaldi Archives for Chest Disease: Vol. 93 No. 1 (2023)
- Michele Vitacca, Beatrice Salvi, Marta Lazzeri, Elisabetta Zampogna, Giancarlo Piaggi, Piero Ceriana, Serena Cirio, Luigino Rizzello, Grazia Lacala, Angelo Longoni, Vittoria Galimberti, Patrizia D'Ambrosio, Enrica Pavesi, Giuseppe La Piana, Antonella Sanniti, Alessandro Morandi, Manoel Vallet, Mara Paneroni, Respiratory rehabilitation for patients with COVID-19 infection and chronic respiratory failure: a real-life retrospective study by a Lombard network , Monaldi Archives for Chest Disease: Vol. 92 No. 3 (2022)
- Elizabeth Swezey, Scott Oster, Kathryn McGhee, Luke Edgecombe, Jody DiGiacomo, L. D. George Angus, Contralateral pneumothorax after central line placement in COVID-19 positive patients , Monaldi Archives for Chest Disease: Vol. 92 No. 2 (2022)
- Mario Tamburrini, Parikshit Thakare, Francesca Zampieri, Angelo Scarda, Alessandra Di Paolo, Giancarlo De Leo, Enrico Gianfagna, Lucia Vietri, Umberto Zuccon, A case report on expanding horizon of endobronchial ultrasound through esophagus , Monaldi Archives for Chest Disease: Vol. 90 No. 3 (2020)
<< < 55 56 57 58 59 60 61 62 63 64 > >>
You may also start an advanced similarity search for this article.
