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Prognostic impact of one-year permanent pacemaker implantation after mitral valve surgery with the Cox-maze procedure.

Eur J Cardiothorac Surg

January 2025

Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.

Objectives: This study aimed to evaluate the prognostic impact of permanent pacemaker (PPM) implantation within the first year after mitral valve (MV) surgery combined with the Cox-maze procedure, focusing on long-term outcomes, including overall mortality, infective endocarditis (IE), and ischaemic stroke.

Methods: We conducted a retrospective cohort study using data from the National Health Insurance Service (NHIS) in South Korea, identifying 10,127 patients who underwent MV surgery with the Cox-maze procedure between 2005 and 2020. Patients were classified into the PPM and non-PPM groups based on PPM implantation within one year postoperatively.

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A 70-year-old man developed intermittent fever with chills, severe anorexia, generalized weakness, and mild exertional difficulty in breathing following posterior chamber intraocular lens replacement surgery for a mature white cataract in the left eye. Laboratory tests revealed persistent negative blood cultures, normocytic and normochromic anemia, neutrophilia, and elevated inflammatory markers despite multiple courses of antibiotics. All other investigations conducted to identify the cause of prolonged fever, including transthoracic echocardiography, were negative.

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The spleen is one site for septic emboli in cases of IE but in patients with splenic abscess when the patient has a suspicious history of autoimmune diseases, splenic aseptic abscess must be ruled out before splenectomy.

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Enterococcus faecalis is responsible for numerous serious infections, and treatment options often include ampicillin combined with an aminoglycoside or dual beta-lactam therapy with ampicillin and a third-generation cephalosporin. The mechanism of dual beta-lactam therapy relies on the saturation of penicillin-binding proteins (PBPs). Ceftobiprole exhibits high affinity binding to nearly all E.

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