Early surgical intervention for infective endocarditis.
Infective endocarditis remains a serious and complex disease with significant morbidity and mortality. Sixty cases of infective endocarditis were retrospectively reviewed, consisting of 41 males and 19 females aged 7 to 50 years (mean, 30 years). Congenital heart disease was diagnosed in 19 of the patients and rheumatic heart disease in 41. Congestive heart failure occurred in 36 and systemic embolism in 8 cases. Blood cultures were positive in only 21.7% of the cases, while vegetations were detected by 2-dimensional echocardiography in 70%. Elective surgery was performed in 57 patients and emergent operation for systemic arterial embolization and/or intractable congestive heart failure in 3 patients. Two patients required reoperation for postoperative bleeding. All but 2 patients had been followed up for 6 to 160 months with no evidence of reinfection. Three patients with mechanical valve implantation later died of intracranial bleeding due to over-anticoagulation. The remaining 55 resumed normal activity. The encouraging outcomes were the result of an aggressive diagnostic approach and early surgical intervention.
Zhu
Hong Sheng
HS
Ren Ji Hospital, Shanghai Second Medical University, Shanghai, People's Republic of China.
Yao
Pei Yan
PY
Zheng
Jia Hao
JH
Pezzella
A Thomas
AT
D000293:Adolescent; D000328:Adult; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects*; D002648:Child; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors