Clinical Characteristics And Surgical Treatment Of Infective Endocarditis With Bicuspid Aortic Valve

This study aimed to evaluate the clinical characteristics and surgical treatment of bicuspid aortic valve (BAV) infective endocarditis (IE) compared with tricuspid aortic valve (TAV) IE in China.The relevant pre-, intra-and post-operative materials of all IE patients undergoing cardiac surgery in our center between January 2003 and December 2012 were investigated and analyzed retrospectively.From January 2003 to December 2012, 345 consecutive IE patients received surgery in our center. A total of 171 native aortic valve IE patients were enrolled in this study, accounting for 49.6% of the total population. Among these 171 IE patients, 29.8% (n = 51) were BAV, and the remaining (n = 120) were TAV. There was a strong male predominance (92.2% versus 70.8%, P = 0.002) and a higher frequency of aortic perivalvular abscess (45.1% versus 18.3%, P < 0.001) in the BAV IE group compared with the TAV IE group. In multivariate analysis, BAV was the only independent predictor associated with an increased risk of aortic perivalvular abscess (OR = 4.365, 95% CI 1.30-14.65, P = 0.017). Six patients died postoperatively and no significant difference was found about in-hospital mortality between the BAV IE group and TAV IE group (2.0% versus 4.2%, P = 0.793).BAV is common in patients with confirmed aortic valve IE. BAV IE patients have a significantly increased risk of perivalvular abscess. Prompt diagnosis and timely surgery for BAV IE patients might be needed to prevent the formation and extension of perivalvular abscess.