Prosthetic valve endocarditis.
Prosthetic valve endocarditis is an infrequent but serious complication of valve surgery. It occurred in 25 (3.2%) of 772 patients who received aortic, mitral or double valve replacement in 1971-1987. The total follow-up time was 3,976 patient years, giving an incidence of 0.63/100 patient years. Staphylococci were the most common of the cultured organisms in early and late infections-60% and 64%, respectively. The endocarditis was disclosed at autopsy in two cases. Treatment was antibiotics alone in 11 cases, and surgery was required in 12, the indication always being congestive heart failure. C-reactive protein level fell more rapidly than erythrocyte sedimentation rate in response to antibiotic or surgical management. The mortality rate was 73% in the antibiotic group and 33% in the surgical group. The findings demonstrated that an infected valve prosthesis should be replaced without delay if complications develop.
Janatuinen
M J
MJ
Department of Surgery, University Central Hospital, Turku, Finland.
Vänttinen
E A
EA
Rantakokko
V
V
Nikoskelainen
J
J
Inberg
M V
MV
D000900:Anti-Bacterial Agents; D001021:Aortic Valve; D002097:C-Reactive Protein / Q000032:analysis; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D008943:Mitral Valve; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D012086:Reoperation; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000628:therapy
D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein