Operation for infective endocarditis: Results after implantation of mechanical valves

被引:64
|
作者
Bauernschmitt, R [1 ]
Jakob, HG [1 ]
Vahl, CF [1 ]
Lange, R [1 ]
Hagl, S [1 ]
机构
[1] Univ Heidelberg, Dept Cardiac Surg, D-69120 Heidelberg, Germany
来源
ANNALS OF THORACIC SURGERY | 1998年 / 65卷 / 02期
关键词
D O I
10.1016/S0003-4975(97)01092-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Operation for acute endocarditis during the active phase violates a basic surgical rule not to implant a foreign body into an infective process, resulting in a high operative mortality and the risk of early recurrent endocarditis. Several investigators analyzing risk factors for perioperative mortality and morbidity presented strategies for more favorable outcomes, but most studies suffer from the drawback of heterogeneous populations observed over a long period of time. Methods. We present a prospective study on 138 patients operated on from March 1988 to March 1996. Patients were only included if the activity of the infection was proved by positive culture of the valve leaflets or by histologic staining. During the observation period, indication for operation, surgical approach, and postoperative antibiotic therapy were standardized as much as possible. After radical debridement of all parts of infected tissue, valve replacement was carded out with mechanical prostheses. Results. The early mortality was 11.5% overall. High New York Heart Association functional classification, advanced age, and staphylococcal disease were significant risk factors for early mortality. The site of infection, multiple valve involvement, and prosthetic valve endocarditis did not affect the outcome. Early recurrent endocarditis was recorded in only 3 patients of the entire series. Conclusions. In case of acute infective endocarditis, valve replacement with mechanical prostheses is a safe procedure, if radical operation and aggressive postoperative antibiotic therapy are performed. For further improvements of the results, earlier operation is advisable in patients with rapidly progressive cardiac deterioration and in most cases of staphylococcal endocarditis.
引用
收藏
页码:359 / 364
页数:6
相关论文
共 50 条
  • [1] Implantation of mechanical valves for infective endocarditis
    Moro, H
    Hayashi, J
    Namura, O
    [J]. ANNALS OF THORACIC SURGERY, 1998, 66 (04): : 1470 - 1470
  • [2] Infective Endocarditis Risk After Percutaneous Pulmonary Valve Implantation With the Melody and Sapien Valves
    Hascoet, Sebastien
    Mauri, Lucia
    Claude, Caroline
    Fournier, Emmanuelle
    Lourtet, Julie
    Riou, Jean-Yves
    Brenot, Philippe
    Petit, Jerome
    [J]. JACC-CARDIOVASCULAR INTERVENTIONS, 2017, 10 (05) : 510 - 517
  • [3] Hemostatic system changes in infective endocarditis patients before and after surgical heart valves operation
    Shatova, O. Olesya
    Feaktsistava, N.
    Kazaeva, N.
    Sudjaeva, S.
    Sudjaeva, O.
    [J]. EUROPEAN JOURNAL OF HEART FAILURE, 2019, 21 : 556 - 556
  • [4] Infective endocarditis on normal valves
    Luaces-Méndez, M
    Sarriá, C
    San Román, JA
    López, J
    Sanmartín, JV
    Fernández, C
    Rodríguez, E
    Vilacosta, I
    [J]. CIRCULATION, 2004, 110 (17) : 567 - 567
  • [5] Long-Term Results After Operations for Active Infective Endocarditis in Native and Prosthetic Valves
    Meszaros, Katharina
    Nujic, Sladjan
    Sodeck, Gottfried H.
    Englberger, Lars
    Koenig, Tobias
    Schoenhoff, Florian
    Reineke, David
    Roost-Kraehenbuehl, Eva
    Schmidli, Juerg
    Czerny, Martin
    Carrel, Thierry P.
    [J]. ANNALS OF THORACIC SURGERY, 2012, 94 (04): : 1204 - 1210
  • [6] Infective endocarditis after transcatheter aortic valve implantation
    Arellano Serrano, C.
    Oteo Dominguez, J. F.
    Garcia Touchard, A.
    Fernandez Diaz, J. A.
    Del Trigo Espinosa, M.
    Calderon Parra, J.
    Ramos Martinez, A.
    Cobo Marcos, M.
    Dominguez Rodriguez, F.
    Monivas Palomero, V.
    Mingo Santos, S.
    Goicolea Ruigomez, J.
    Segovia Cubero, J.
    [J]. EUROPEAN HEART JOURNAL, 2021, 42 : 1715 - 1715
  • [7] The prognosis of infective endocarditis treated with biological valves versus mechanical valves: A meta-analysis
    Tao, Ende
    Wan, Li
    Wang, WenJun
    Luo, YunLong
    Zeng, JinFu
    Wu, Xia
    [J]. PLOS ONE, 2017, 12 (04):
  • [8] INFECTIVE ENDOCARDITIS ON STENOTIC AORTIC VALVES
    DELAHAYE, JP
    LOIRE, R
    MILON, H
    DEGEVIGNEY, GD
    DELAHAYE, F
    BOISSONNAT, P
    ZAMBARTAS, C
    ETIENNE, J
    MALQUARTI, V
    [J]. EUROPEAN HEART JOURNAL, 1988, 9 : 43 - 49
  • [9] EARLY INFECTIVE ENDOCARDITIS ON PROSTHETIC VALVES
    CHASTRE, J
    TROUILLET, JL
    [J]. EUROPEAN HEART JOURNAL, 1995, 16 : 32 - 38
  • [10] RISK OF INFECTIVE ENDOCARDITIS OF NATIVE VALVES
    MICHEL, PL
    DEGEVIGNEY, G
    [J]. ARCHIVES DES MALADIES DU COEUR ET DES VAISSEAUX, 1993, 86 (12): : 1877 - 1882