Original ArticlesOperation for Infective Endocarditis: Results After Implantation of Mechanical Valves
Section snippets
Patients
In an 8-year period between March 1988 and March 1996, 138 patients underwent operation for acute infective endocarditis. There were 29 women and 109 men (mean age, 50.5 years; range, 20 to 78 years). One hundred twenty-three patients had endocarditis of the native valve, whereas in 15 patients prosthetic valve endocarditis was present (Table 1). Patients were only included in the study if the endocarditis had to be considered “definite” according to the criteria proposed by von Reyn [7], that
Mortality
The early mortality (within 30 days after the operation) in this series was 11.5% (16 patients). The main reasons for death were cardiac failure (11 patients) and septic multiorgan failure (3 patients); sepsis in these patients was not associated with recurrent or persistent infection of the valve prosthesis. Two patients died in tabula from uncontrollable bleeding. Both had a long-standing history of endocarditis leading to severe pancarditis and infectious alteration of atrial and ventricular
Comment
Surgical treatment of an acute infective endocarditis by valve replacement still remains a challenge to the surgeon, because it does not only require hemodynamic repair, but also special emphasis on the eradication of the infectious focus to prevent early postoperative colonization of the prosthesis by remaining microorganisms. This goal can be achieved by the combination of aggressive surgical therapy and adequate postoperative intensive care.
References (19)
- et al.
Management of infective endocarditis17 years’ experience
Ann Thorac Surg
(1987) - et al.
Aortic valve replacement for active infectious endocarditis in 108 patients
J Thorac Cardiovasc Surg
(1992) - et al.
Aortic valve infection
J Thorac Cardiovasc Surg
(1992) - et al.
Effects of changes in management of active infective endocarditis on outcome in a 25-year period
Am J Cardiol
(1993) - et al.
Surgical treatment of active infective endocarditis with paravalvular involvement
J Thorac Cardiovasc Surg
(1994) - et al.
Management of persistent tricuspid endocarditis with transplantation of cryopreserved mitral homografts
J Thorac Cardiovasc Surg
(1994) - et al.
Long-term results of operation for paravalvular abscess
Ann Thorac Surg
(1996) - et al.
Active native valve endocarditisdeterminants of operative death and late mortality
Ann Thorac Surg
(1997) - et al.
The surgical treatment of infective endocarditis
World J Surg
(1989)