Cardiac conduction abnormalities complicating native valve active XXXX .

@entity1 @entity886 @entity281 @entity340 @entity204 @entity616 @entity884
Two hundred eleven episodes of native valve active @entity884 treated at the Massachusetts General Hospital between 1975 and 1983 were reviewed. The aortic (36%) and mitral (33%) valves were most frequently involved, but in 21% of the cases the site of infection could not be localized. Streptococcal (50%) and staphylococcal (35%) species were the most frequently isolated pathogens. New or changing ("unstable") conduction abnormalities developed in 9% of the @entity1 , while an additional 7% had conduction abnormalities of "indeterminate" age. Unstable conduction block was more likely to develop in @entity1 with aortic valve @entity884 than in those with @entity281 . Surgery was performed in 23% of the @entity1 . Unstable conduction abnormalities were significantly associated with valve replacement, but in a multivariate analysis, this effect could be explained by the site of @entity340 . The mortality rate was 20%. @entity1 with unstable conduction abnormalities had a significantly higher mortality rate, even after other significant predictors of @entity204 (age, type of causative organism) were taken into account. @entity1 whose conduction changes persisted had a worse prognosis than those with @entity616 . Although more hemodynamically compromised, @entity1 with unstable conduction block who underwent valve replacement did at least as well as those given medical therapy alone. @entity1 with native valve active @entity884 in whom persistent, unstable conduction abnormalities develop without other identifiable cause, especially in the presence of @entity886 , should be considered for valve replacement.
