Infective endocarditis. Surgical therapy.
OBJECTIVE
To assess the major causes of surgical morbidity and mortality in patients with infective endocarditis operated upon in a regional cardiology center.


METHODS
Thirty-four patients underwent surgical treatment for infective endocarditis. Their ages ranged from 20 to 68 years (mean of 40.6) and 79% were males. Their NYHA functional classes were as follows: IV - 19 (55.8%) patients; III - 12 (35.2%) patients; II - 3 (8.8%) patients. Blood cultures were positive in only 32% of the cases. Eight patients had already undergone previous cardiac surgery, whose major indication (82.3%) was heart failure refractory to clinical treatment.


RESULTS
Four (11.7%) patients died at the hospital. Follow-up was complete in 26 (86%) patients. Five (14.7%) patients died later, 12, 36, 48, 60, and 89 months after hospital discharge. Of the 21 patients being currently followed up, 1 is in NYHA functional class III, and 5 in NYHA functional class II.


CONCLUSIONS
A high degree of clinical suspicion, at an early diagnosis, and indication of surgical treatment prior to deterioration of left ventricular function and installation of generalized sepsis may improve prognosis.
Fragomeni
Luís Sérgio de Moura
LS
Hospital São Vicente de Paulo, Universidade de Passo Fundo, RS, Brazil. fragomeni@annex.com.br
Vieira
Fabiano Fernandes
FF
Bajerski
Júlio Cesar de Mello
JC
Falleiro
Roque Paulo
RP
Hoppen
Gustavo
G
Sartori
Iselso
I
D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D004697:Endocarditis, Bacterial / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011379:Prognosis; D012189:Retrospective Studies