Emergency valve replacement for active infective endocarditis.
During the last 12 years, 14 patients were subjected to emergency heart valve replacement in acute bacterial endocarditis. Operative mortality was 21% (3/14); significant postoperative periprosthetic regurgitation or reinfection occurred in none of the survivors. Risk factors with unfavourable prognosis are: (1) virulent pathogens ("Non-Viridans"-germs); (2) previously normal heart valves; (3) acute aortic insufficiency with premature closure of the mitral valve; (4) floating vegetations shown by echocardiography. Our results provide further evidence for the efficacy of early surgical intervention in patients with bacterial endocarditis with an unfavourable etiology or a complicated course.
Stulz
P
P
Division of Cardiology, University Hospital, Basel, Switzerland.
Pfisterer
M
M
Jenzer
H R
HR
Hasse
J
J
Grädel
E
E
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery; D004630:Emergencies; D004697:Endocarditis, Bacterial / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies