[Surgical treatment of active infective endocarditis and prosthetic valve endocarditis].
Fifteen patients with active native valve endocarditis (NVE) and 5 with prosthetic valve endocarditis (PVE) were subjected to this study. Among the patients with NVE, one of 10 with simple destruction of leaflets and 2 of 5 with annular infection died postoperatively of cerebral bleeding and persistent infection. Five patients with annular infection, whose microorganisms were Streptococcus faecalis, Staphylococcus epidermidis and gram-negative coccus, had a shorter duration from onset to operation (mean 38 days) compared with the others (mean 85 days). A patient with NVE requires an urgent operation, especially when these microorganisms are identified. Among those with PVE, 3 underwent operation at the active phase and one at the chronic phase. Two patients with mechanical valve endocarditis by Staphylococcus and Candida died, but the other 2 with bioprosthetic valve endocarditis by alpha-Streptococcus survived, because infection was localized in the leaflets. Another patient with mechanical valve endocarditis by alpha-Streptococcus survived with conservative management. While a patient with bioprosthetic valve endocarditis requires an early operation as well as NVE, a patient with mechanical valve endocarditis requires selected management considering the microorganism and general condition.
Sugimoto
T
T
Division of Cardiovascular Surgery, Hyogo Brain and Heart Center, Himeji.
Ogawa
K
K
Asada
T
T
Mukohara
N
N
Nishiwaki
M
M
Higami
T
T
Kawamura
T
T
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001705:Bioprosthesis; D002177:Candidiasis / Q000601:surgery; D004696:Endocarditis / Q000601:surgery*; D004697:Endocarditis, Bacterial / Q000601:surgery; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000601:surgery*; D013203:Staphylococcal Infections / Q000601:surgery