Surgery for Active Infective Endocarditis

Hg, Borst; Hetzer, Roland; Deyerling, W.

doi:10.1055/s-2007-1022421

Cited by 21 publications

(4 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The principal indication for surgical therapy was rapid or progressive hemodynamic deterioration secondary to valvular and paravalvular destruction.o 10, 26 Very often, though, operation may come too late if the indication is guided by symptoms of cardiac failure, inasmuch as the operative mortality has been shown to correlate with the degree of congestive heart failure. 10,20,24 In this context, the operative mortality rate of 21% observed in our patients appears acceptable in view of the large number of patients with advanced congestive heart failure. Sixty-six percent of patients in the present series were in NYHA class IV, and five were in shock before operation.…”

Section: Discussionmentioning

confidence: 62%

Surgical treatment of active infective endocarditis with paravalvular involvement

Watanabe

Haverich

Speier

et al. 1994

The Journal of Thoracic and Cardiovascular Surgery

100

View full text Add to dashboard Cite

Surgical treatment of active infective endocarditis with paravalvular involvement Aortic root infection remains a challenging problem in the surgical treatment of both native and prosthetic valve endocarditis. Between 1980 and 1991,73 patients with active aortic valve endocarditis and paravalvular infection underwent operation. Indications for operation included congestive heart failure and uncontrolled sepsis. Aortic root abscesses were located in the noncoronary anulus or in the aorticomitral junction in 45 % of cases, followed by the subannular interventricular septum in 23 % • Two patients had an aorticoatrial fistula, seven an interventricular septal defect. Total or partial left ventricular-aortic dehiscence was observed in 27 patients. All patients underwent aortic valve replacement, nine with simultaneous mitral valve operations. Two of the latter required patch reconstruction of the destroyed aorticomitral septum with double valve replacement. Reconstruction of the aortic base was possible in 16 patients, whereas in 12 total replacement of the aortic root was necessary. In one patient, supracoronary aortic valve replacement was used. Recently, topical application of antibiotics in fibrin sealant was used in 25 patients. The operative mortality rate was 21 % and correlated to preoperative uncontrolled sepsis and the presence of extensive root destruction. Operation for active endocarditis of the aortic root requires radical, individualized techniques and results in an acceptable operative and long-term risk. The use of an antibiotic fibrin compound appears to be a useful prophylactic tool to prevent postoperative residual endocarditis.

show abstract

Section: Discussionmentioning

confidence: 62%

Surgical treatment of active infective endocarditis with paravalvular involvement

Watanabe

Haverich

Speier

et al. 1994

The Journal of Thoracic and Cardiovascular Surgery

100

View full text Add to dashboard Cite

show abstract

“…The strategy of operation in patients suffering from active infective aortic valve endocarditis is dependent on how much destruction of paraannular and subannular tissue has taken place. Invasion of infection into periannular structures of the aortic valve can produce technical problems that can only be managed in dependence on the individual situation [7,8,9]. Most of our cases were treated with a homograft or the Shelhigh NoReact w Superstentlesse and Stentless Aortic Valve Conduite as an alternative.…”

Section: Surgerymentioning

confidence: 90%

Aortic root abscess and secondary infective mitral valve disease: results of surgical endocarditis treatment

Siniawski

Grauhan

Hofmann

et al. 2005

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

show abstract

“…A predilectio n of the ao rtic pro sthesis fo r rVE was also reported by Tu rina (9) and Borst er al. (4). r VE may cau se so me additiona l complications which are summarized in Table 5.…”

Section: Mechanical Disorder S Of Prosthetic Valves May Be Ca Use D Bmentioning

confidence: 99%

Reoperations for Malfunction of Heart Valve Prostheses, Especially with Endocarditis

Hd¹,

Horstkotte²,

Evagelopoulos³

et al. 1987

Thorac cardiovasc Surg

View full text Add to dashboard Cite

Following the increasing number of patients with heart valve replacement and an extended indication (older age groups, acute infective endocarditis, multivalvular procedures) the indicence of malfunction of valve prostheses is continuously growing. The prognosis of patients with a malfunctioning prosthesis mainly depends on early diagnosis and adequate therapy. In a retrospective study (1970 to 1984) 3,533 implanted heart valve prostheses were followed up and the cases with malfunction (n = 150; 4.2%) were analyzed. During the follow-up period after 1963 mitral valve replacements (MVR) there were 78 cases of malfunction (4.6%), after 1806 aortic valve replacements (AVR) 73 (4.1%), and after 34 tricuspid valve replacements (TVR) 4 malfunctions (11.8%). These malfunctions concerned periprosthetic leakages (n = 65), prosthetic endocarditis (n = 42), prosthetic valve thrombosis (n = 13), mechanical dysfunction including bioprosthetic degeneration (n = 17), valve related hemolysis (n = 3), and unsatisfactory hemodynamics (n = 10). Special attention was turned to the problem of prosthetic endocarditis (1963-1984) found in a total of 71 patients following 3,878 prosthetic valve replacements (1.9%). In 42 reoperated cases (1970-1984) the causing microorganisms were analyzed, demonstrating staphylococci in a leading position. Secondary complications and additional risk factors are discussed. There has been no change concerning the basis and the strategy of management for prosthetic endocarditis for many years: After a short time of conservative management with tested antibiotics, early reoperation and exchange of the prosthesis seems to be the optimal therapy, despite a distinctly high postoperative mortality (17%).(ABSTRACT TRUNCATED AT 250 WORDS)

show abstract

Surgery for Active Infective Endocarditis

Cited by 21 publications

References 5 publications

Surgical treatment of active infective endocarditis with paravalvular involvement

Surgical treatment of active infective endocarditis with paravalvular involvement

Aortic root abscess and secondary infective mitral valve disease: results of surgical endocarditis treatment

Reoperations for Malfunction of Heart Valve Prostheses, Especially with Endocarditis

Contact Info

Product

Resources

About