title: Early surgical intervention for infective endocarditis.
abstract: 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.
authors.affiliation: Ren Ji Hospital, Shanghai Second Medical University, Shanghai, People's Republic of China.
authors.forename: Hong Sheng
authors.initials: HS
authors.lastname: Zhu
authors.forename: Pei Yan
authors.initials: PY
authors.lastname: Yao
authors.forename: Jia Hao
authors.initials: JH
authors.lastname: Zheng
authors.forename: A Thomas
authors.initials: AT
authors.lastname: Pezzella
mesh_terms: 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