| Summary: | Background: Aim of this study was to evaluate the outcomes of endocarditis patients undergoing valve surgery with the Cytosorb<sup>®</sup> hemoadsorption (HA) device during cardiopulmonary bypass. Methods: From 2009 until 2019, 241 patients had undergone valve surgery due to endocarditis at the Department of Cardiac Surgery, University Hospital of Basel. We compared patients who received HA during surgery (<i>n</i> = 41) versus patients without HA (<i>n</i> = 200), after applying inverse probability of treatment weighting. Results: In-hospital mortality, major adverse cardiac and cerebrovascular events and postoperative renal failure were similar in both groups. Demand for norepinephrine (88.4 vs. 52.8%; <i>p</i> = 0.001), milrinone (42.2 vs. 17.2%; <i>p</i> = 0.046), red blood cell concentrates (65.2 vs. 30.6%; <i>p</i> = 0.003), and platelets (HA vs. Control: 36.7 vs. 9.8%; <i>p</i> = 0.013) were higher in the HA group. In addition, a higher incidence of reoperation for bleeding (34.0 vs. 7.7 %; <i>p</i> = 0.011), and a prolonged length of in-hospital stay (15.2 (11.8 to 19.6) vs. 9.0 (7.1 to 11.3) days; <i>p</i> = 0.017) were observed in the HA group. Conclusions: No benefits of HA-therapy were observed in patients with infective endocarditis undergoing valve surgery.
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