Non-bacterial thrombotic endocarditis surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]

Overview

Surgery is not the first-line treatment option for patients with non-bacterial thrombotic endocarditis and is usually reserved for patients with either heart failure, acute valve rupture, or recurrence of thromboembolism despite adequate anticoagulation. It is important to weigh the risks associated with the patient’s underlying condition with the benefits of surgery.

Indications

Surgery is not the first-line treatment option for patients with non-bacterial thrombotic endocarditis^[1].
Surgery to replace or repair the valve is usually reserved for patients with either heart failure, acute valve rupture, or recurrence of thromboembolism despite adequate anticoagulation^[2].
Mitral valve replacement surgery has an operative mortality of as high as 25% in patients with Libman-Sacks endocarditis.
The main reason for surgery in NBTE is the prevention of recurrent thromboembolism.
As opposed to infective endocarditis where the entire valve may need to be removed, valve preservation is possible in NBTE^[3].
When considering surgery as an option, it is important to weigh the risks associated with the patient’s underlying condition with the benefits of surgery^[4].

References

↑ Roldan CA, Shively BK, Crawford MH (November 1996). “An echocardiographic study of valvular heart disease associated with systemic lupus erythematosus”. N. Engl. J. Med. 335 (19): 1424–30. doi:10.1056/NEJM199611073351903. PMID 8875919.
↑ Rabinstein AA, Giovanelli C, Romano JG, Koch S, Forteza AM, Ricci M (March 2005). “Surgical treatment of nonbacterial thrombotic endocarditis presenting with stroke”. J. Neurol. 252 (3): 352–5. doi:10.1007/s00415-005-0660-z. PMID 15726268.
↑ “Non-bacterial Thrombotic Endocarditis | IntechOpen”.
↑ Aryana A, Esterbrooks DJ, Morris PC (December 2006). “Nonbacterial thrombotic endocarditis with recurrent embolic events as manifestation of ovarian neoplasm”. J Gen Intern Med. 21 (12): C12–5. doi:10.1111/j.1525-1497.2006.00614.x. PMC 1924740. PMID 16965557.

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[pmid8875919-1] Roldan CA, Shively BK, Crawford MH (November 1996). “An echocardiographic study of valvular heart disease associated with systemic lupus erythematosus”. N. Engl. J. Med. 335 (19): 1424–30. doi:10.1056/NEJM199611073351903. PMID 8875919.

[pmid15726628-2] Rabinstein AA, Giovanelli C, Romano JG, Koch S, Forteza AM, Ricci M (March 2005). “Surgical treatment of nonbacterial thrombotic endocarditis presenting with stroke”. J. Neurol. 252 (3): 352–5. doi:10.1007/s00415-005-0660-z. PMID 15726268.

[urlNon-bacterial_Thrombotic_Endocarditis_|_IntechOpen-3] “Non-bacterial Thrombotic Endocarditis | IntechOpen”.

[pmid16965557-4] Aryana A, Esterbrooks DJ, Morris PC (December 2006). “Nonbacterial thrombotic endocarditis with recurrent embolic events as manifestation of ovarian neoplasm”. J Gen Intern Med. 21 (12): C12–5. doi:10.1111/j.1525-1497.2006.00614.x. PMC 1924740. PMID 16965557.

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Non-bacterial thrombotic endocarditis surgery

Overview

Indications

References

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