OBJECTIVES The prevalence of infectious endocarditis (IE) in intravenous drug users (IDUs) is increasing, and the number of patients who need surgery is also rising. Relatively little is known about the short-term and long-term outcomes of these operations. METHODS This study is a retrospective analysis of our institutional results, focussing on risk factors for perioperative death, major adverse events and long-term survival. A total of 50 of the 66 (75.75%) patients had postoperative follow-up, and the mean follow-up time was 53.9 ± 9.66 months. Patients were divided into 2 groups depending on whether they were having their first operation or were being reoperated for recurrent IE. RESULTS From March 2006 to December 2015, a total of 158 patients underwent surgery for IE; 72 (45.6%) of them were identified as active IDUs. The operative mortality in IDUs was 8.33% (6 patients), with no significant difference between the 2 groups (P = 0.6569). Survival rates at 1 year, at 3 years and at the end of follow-up were 92%, 72% and 64%, respectively. There was significantly worse survival of patients with recurrent IE (log-rank test, P = 0.03). CONCLUSIONS Although the short-term results of operation for IE in IDUs are good, long-term outcomes are not satisfactory. The survival of patients with recurrence of IE caused by return to intravenous drug use is significantly worse.

Falešné aneuryzma-pseudoaneuryzma (PSA)-levé komory se vytvoří, pokud se ruptura srdeční stěny překryje a ohraničí perikardem ve vak, který dále komunikuje úzkým krčkem s dutinou levé komory. (1) Patogeneze vzniku ruptury srdeční stěny je komplexní proces ovlivněný řadou faktorů. (2) Pokud se vyvine PSA, jde o tenkostěnný útvar tvořený perikardem a organizovaným hematomem bez endokardu či myokardu, na rozdíl od pravého aneuryzmatu. (3) Jeho výskyt je vzácný, prevalence neznámá a prognóza vážná. Diagnostickým zlatým standardem byla ventrikulografie (diagnostická přesnost ≥ 85 %). (4) V současné době se dává přednost magnetické rezonanci (MR) a echokardiografii (ECHO). (5) V praxi se obvykle

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