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We analyzed 50 cases of bicuspid aortic valve endocarditis in patients who presented to St. Thomas Hospital from 1970 through 1998. These presented 12.3% of the 408 cases of native valve endocarditis (NVE). All patients were male, and their mean age was 39 years. Forty-five of the 50 cases were pathologically proven; 47 were clinically definite according to the Duke criteria and 49 according to our modifications of the Duke criteria. Viridans streptococci and staphylococci accounted for 72% of cases. The prevalences of clinical features were similar to those seen in NVE: fever (temperature �38�C, 74%) and malaise (70%), although dyspnea was more frequent (36%). There was a high incidence of serious complications (72% heart failure; 30% periannular abscesses). Surgery was required during the initial admission in 82% of cases. Overall mortality was 14%, and surgical mortality was 9%. Few patients knew they had a "heart condition", and a bicuspid aortic valve was detected in only 35% of echocardiograms performed before surgery. |
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abscess,intracerebral
abscess,perivalvular
aortic valve,bicuspid
aortic valve,lesion of
bacterial endocarditis,neurologic manifestations of
cardiac surgery
caries
cerebral embolism
cerebrovascular accident
cerebrovascular accident,cardiac disease causing
complications
congenital heart disease
congestive heart failure
dental procedure,neurologic complications with
dyspnea
echocardiogram
echocardiogram,transesophageal,false negative
echocardiogram,transthoracic
echocardiogram,transthoracic,false negative
endocarditis
endocarditis,acute bacterial
familial
fever
gender
heart murmur
heart valve surgery
infection
malaise
mental status,abnormal
misdiagnosis
mortality
myocardial abscess
splenomegaly
staphylococcus aureus
streptococcal infection
streptococcus viridans
treatment of neurologic disorder
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