Multi-valvular endocarditis

ObjectiveSeventy-seven cases of native valve infective endocarditis as determined by the Duke criteria, were reviewed to determine the incidence and clinical features of multi-valvular endocarditis.MethodsFourteen of 77 patients (18%) had multi-valvular endocarditis most commonly involving the mitral and aortic valves. Staphylococcus aureus (43%) and viridans streptococci (36%) were the most common organisms causing multi-valvular endocarditis.ResultsDefinite or probable vegetations were found in 50% of the patients by two-dimensional transthoracic echocardiograph and/or transesophageal echocardiograph, and possible vegetations were detected in 21%. The overall mortality in our series was 21%; 29% underwent valve replacement and 50% were treated medically. The major complications of multi-valvular endocarditis were congestive heart failure (64%), acute renal failure (50%), embolic events (21%), and splenic abscess/infarcts (21%).ConclusionsOur data suggests complications of multi-valvular endocarditis, compared with uni-valvular endocarditis are similar except for heart failure. Heart failure is statistically more common in multi-valvular endocarditis (P ≤ 0.002)