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Residual patient, anatomic, and surgical obstacles in treating active left-sided infective endocarditis  Syed T. Hussain, MD, Nabin K. Shrestha, MD, Steven.

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Presentation on theme: "Residual patient, anatomic, and surgical obstacles in treating active left-sided infective endocarditis  Syed T. Hussain, MD, Nabin K. Shrestha, MD, Steven."— Presentation transcript:

1 Residual patient, anatomic, and surgical obstacles in treating active left-sided infective endocarditis  Syed T. Hussain, MD, Nabin K. Shrestha, MD, Steven M. Gordon, MD, Penny L. Houghtaling, MS, Eugene H. Blackstone, MD, Gösta B. Pettersson, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 148, Issue 3, Pages e4 (September 2014) DOI: /j.jtcvs Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Survival after surgery for native or prosthetic valve left-sided valve infective endocarditis (IE). Each symbol represents a death, and vertical bars represent the 68% confidence limits, equivalent to ±1 standard error. Solid green lines indicate native valve endocarditis; dashed orange lines, prosthetic valve endocarditis; filled circles, aortic valve IE alone; open circles, mitral valve IE alone; and triangles, aortic and mitral valve IE. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Survival after surgery for invasive versus noninvasive left-sided infective endocarditis according to valve position. Solid blue lines indicate noninvasive infective endocarditis; and dashed red lines, invasive infective endocarditis. Each symbol represents a death, and vertical bars represent the 68% confidence limits, equivalent to ±1 standard error. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Survival after surgery for invasive infective endocarditis for propensity-matched and unmatched isolated aortic and mitral valve cases. Each symbol represents a death, and vertical bars represent the 68% confidence limits, equivalent to ±1 standard error. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

5 Figure E1 Results of propensity matching for various isolated invasive mitral valve infective endocarditis and isolated invasive aortic valve disease. A, Mirrored histogram of propensity score distribution. Darkened bars represent matched patients. B, Covariable balance before and after matching. Values on the horizontal axis represent the percentage standardized difference* between mitral valve and aortic valve IE groups. C, Standardized differences* between matched and unmatched cases. PVE, prosthetic valve endocarditis; CoNS, coagulase-negative staphylococci; COPD, chronic obstructive pulmonary disease; LVEF, left ventricular ejection fraction; Afib, atrial fibrillation; NYHA, New York Heart Association; GP, gram-positive; BUN, blood urea nitrogen; Preop, preoperative; DM, diabetes mellitus; LA, left atrial; AV, aortic valve; MV, mitral valve. *Austin PC, Mamdani MM. A comparison of propensity score methods; a case study estimating the effectiveness of post-MI statin use. Stat Med. 2006;25: The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

6 Figure E2 Survival after surgery for left-sided infective endocarditis (IE). Each symbol represents a death, and vertical bars represent the 68% confidence limits, equivalent to ±1 standard error. A, Stratified by involved valve. Filled circles indicate aortic valve IE alone; open circles, mitral valve IE alone; and triangles, aortic and mitral valve IE. B, Stratified by native (solid green line and open circles) versus prosthetic (dashed orange line and filled circles) valve endocarditis. C, Invasive (dashed red line and filled circles) versus noninvasive (solid blue line and open circles) disease. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

7 Figure E3 Survival after surgery for invasive aortic valve infective endocarditis (IE) versus mitral disease. Each symbol represents a death, and vertical bars represent the 68% confidence limits, equivalent to ±1 standard error. Solid lines indicate parametric estimates enclosed within a 68% confidence band. Orange solid line and filled circles indicate aortic valve IE; and purple solid line and open circles, mitral valve IE. A, Unadjusted survival. B, Propensity-matched patients. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

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