Piergiorgio Scotton

Management of patients with infective endocarditis by a multidisciplinary team approach: an operative protocol.

Even in the modern era of advanced diagnostic imaging, improved antibiotic therapy and potentially curative surgery, infective endocarditis remains a serious disease with high rates of morbidity and mortality. Reasons for such a persistently poor outcome may be represented by the changing epidemiology and microbiology, with new groups of patients at risk and new and more aggressive microorganisms. However, the inadequate use of both diagnostic (blood cultures and echocardiography) and therapeutic (antibiotics and surgery) means can influence the generally delayed diagnosis and poor prognosis seen in patients with infective endocarditis. We tried to identify the critical points in the management of patients with infective endocarditis and to elaborate a formal multidisciplinary approach based on the strict collaboration of specialists in infectious diseases, microbiology, cardiology and cardiac surgery. We hypothesized that this approach could increase the adherence to the published guidelines, and could represent a means to improve the outcome of patients with infective endocarditis.

Complete and partly unexpected diagnostic findings at 18F-FDG-PET/CT scanning in patients with suspected prosthetic valve endocarditis

A 76-year-old male with previous aortic valve replacement presented with intermittent fever. No apparent source of infection was found at clinical inspection. Blood cultures were positive for Streptococcus anginosus . Infective endocarditis was suspected and transoesophageal echocardiography (TOE) was performed. The exam showed a mildly degenerated bioprosthesis with thickened leaflets; there was an increased gradient (mean gradient 22 mmHg); neither valvular nor perivalvular regurgitation was identified. These findings were suspect for …

CHANGING SPECTRUM OF INFECTIVE ENDOCARDITIS: REVIEW OF 707 PATIENTS OVER 26 YEARS

Background: In the last decades the clinical and epidemiological profile of infective endocarditis (IE) has considerably changed. The aim of this study is to assess the temporal variations of IE and to identify factors related to in-hospital mortality in a large cohort of patients observed over a 26