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Purpose <p>International guidelines recommend invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) before surgery for infective endocarditis (IE). Given the low level of evidence for this recommendation, we aimed to assess the impact of coronary evaluation in this context.</p> Methods <p>This multicenter retrospective study included adult patients diagnosed with IE who underwent cardiac surgery, and whose coronary status was considered unknown at the time of IE diagnosis. Patients were divided in two groups: those who underwent a coronary evaluation (C group) and those who did not (NC group). The primary endpoint was to determine the prevalence of coronary evaluation during the preoperative workup for IE. Secondary endpoints included the safety of coronary evaluation, the prevalence of coronary revascularization, and the one-year post-operative prognosis.</p> Results <p>323 patients were included, with 43% in the NC group and 57% in the C group (ICA for 149 patients, CCTA for 35 patients). Coronary evaluation found no lesion, non-significant coronary artery disease (CAD), and significant CAD in 51.1%, 28.8%, and 20.1% of cases, respectively. Thirteen patients underwent coronary artery bypass graft during the IE surgery. Tolerability of ICA was excellent: no embolic events and no additional renal toxicity.</p> Conclusion <p>While coronary evaluation was recommended for almost all patients, it was only performed in just over half of the cases. Preoperative coronary assessment remains useful and safe, but should probably not delay urgent valvular surgery.</p>

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Preoperative coronary evaluation in valve surgery for infective endocarditis: findings from a multicenter retrospective study

  • 期刊论文

  • 发表日期：

    2025年11月24日

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  • Lucas Armange,
  • Pauline Blanc Petitjean,
  • Audrey Le Bot,
  • David Luque Paz,
  • Raphaël Lecomte,
  • Sylvain Jaffuel,
  • Pierre-Guillaume Piriou,
  • Vincent Letocart,
  • Romain Didier,
  • Sam Sharobeem,
  • Marc Bedossa,
  • Erwan Flecher,
  • Pierre Tattevin,
  • Vincent Auffret,
  • Matthieu Revest

摘要

Purpose

International guidelines recommend invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) before surgery for infective endocarditis (IE). Given the low level of evidence for this recommendation, we aimed to assess the impact of coronary evaluation in this context.

Methods

This multicenter retrospective study included adult patients diagnosed with IE who underwent cardiac surgery, and whose coronary status was considered unknown at the time of IE diagnosis. Patients were divided in two groups: those who underwent a coronary evaluation (C group) and those who did not (NC group). The primary endpoint was to determine the prevalence of coronary evaluation during the preoperative workup for IE. Secondary endpoints included the safety of coronary evaluation, the prevalence of coronary revascularization, and the one-year post-operative prognosis.

Results

323 patients were included, with 43% in the NC group and 57% in the C group (ICA for 149 patients, CCTA for 35 patients). Coronary evaluation found no lesion, non-significant coronary artery disease (CAD), and significant CAD in 51.1%, 28.8%, and 20.1% of cases, respectively. Thirteen patients underwent coronary artery bypass graft during the IE surgery. Tolerability of ICA was excellent: no embolic events and no additional renal toxicity.

Conclusion

While coronary evaluation was recommended for almost all patients, it was only performed in just over half of the cases. Preoperative coronary assessment remains useful and safe, but should probably not delay urgent valvular surgery.