Early Extraction Versus Conservative Management in Patients With Noninfected Cardiac Implantable Electronic Devices Undergoing Cardiac Surgery for Left-Sided Infective Endocarditis

August 28, 2025

Submitted by: Mateo Marin-Cuartas

Source: The Journal of Thoracic and Cardiovascular Surgery

Source URL: https://www.jtcvs.org/article/S0022-5223(25)00570-7/abstract

Keywords:

Cardiac

Author(s): Mateo Marin-Cuartas, Zara Dietze, Sebastian Freiburger, Carolyn Weber, Maximilian Luehr, Manuela De La Cuesta, Gottfried T. Drywa, Guillermo Stöger, Shekhar Saha, Asen Petrov, Artur Lichtenberg, Christian Hagl, Hug Aubin, Klaus Matschke, Mahmoud Diab, Payam Akhyari, Sems-Malte Tugtekin, Thorsten Wahlers, Lenard Conradi, Mohammed Morjan, Alexey Dashkewich, David Holzhey, Philipp Kiefer, Martin Misfeld, Suzanne de Waha, Torsten Doenst, Michael A. Borger

In this retrospective study, the authors analyzed outcomes in 245 patients with left-sided infective endocarditis (IE) and noninfected cardiac implantable electronic devices (CIEDs) who underwent cardiac surgery, using data from the CAMPAIGN Registry, which included 4,917 patients operated on between 1994 and 2018. Two groups were compared: those who underwent CIED extraction (100 patients, 40.8 percent) and those who did not (145 patients, 59.1 percent). After propensity score matching, 74 pairs were analyzed, revealing the 30-day mortality was 13.5 percent in the extraction group vs 20.3 percent in the nonextraction group (p=0.23). Patients who underwent device extraction had significantly longer ICU stays (median of 8 vs. 4 days; p=0.003) and hospital stays (median of 24 vs. 17 days; p