Surgical Treatment of Bacterial Endocarditis

Abstract

Valve replacement was performed during a 7-year period in 27 patients with acute or subacute infective endocarditis. Twenty-three patients had single valve affection--16 aortic and 7 mitral--and 4 patients had affection of both the aortic and mitral valves. Eight of the patients with aortic valve lesion had congenital aortic valve stenosis and 2 of the mitral patients had mitral prolapse. Two patients were operated upon only on the echocardiographic finding of valvular vegetations. The rest of the patients were operated because of cardiac insufficiency, intractable infection or peripheral embolization. Five patients died and 22 patients (82%) were discharged. One of these patients died in the follow-up period. The remaining 21 patients all belong to class I or II (NYHA) postoperatively. There were no cases of reinfection. Emphasis is placed on the use of echocardiography in detecting valvular vegetations, and the need to take the proper surgical action as a result of this finding, even in asymptomatic patients.

Risk Factors for Early and Late Outcome after Surgical Treatment of Native Infective Endocarditis

“…The operative mortality in our series was 17%, which accords well with results in comparable studies (2, 6, 15,16,18,21). Operative mortality of 4.3% was reported in 23 patients with isolated aortic valve replacement before anular abscess had developed (3).…”

Pseudoaneurysm of the Left Ventricte as a Complication of Septic Embolism

“…and aor tic valve lesions were present in 70 % (3). Veilsted and co-workers fo und 2 fatal cases of septic embolization to a coronary artery in 27 cases of infective endocarditis (13).…”

“…thus the indication for operation was clear (I , 13), but the patient was initially treated conservat ively because of the recent AM I. When the decision to operate was taken, preoperative coronary angiography and ventriculography were not performed due to the risk of embolization (13), This case report is presented to illustrate a rare cause of PA and the successful outcome of surgical management.…”