[Aortic homograft implantation in severe endocarditis].
BACKGROUND
Severe endocarditis of the native aortic valve or a prosthetic valve with destruction of the cusps, paravalvular abscess formation and/or fistulas caused by aggressive bacteria has a mortality of almost 100% without surgery. The objective was to evaluate the results of treatment with an aortic homograft in combination with antibiotics.


METHODS
24 patients with either aortic prosthetic valve endocarditis (n = 16) or severe aortic endocarditis (n = 8) were operated with implantation of an aortic homograft at a Danish university hospital from 1997-2006. Staphylococcus species were the most common pathogens followed by streptococcus. Intravenous antibiotic therapy was started before surgery and continued for 4-6 weeks. The patients were followed-up for (1/2)-10 years (mean 5 years).


RESULTS
3 patients with prosthetic valve endocarditis died within the first 24 hours from heart failure. 2 of these patients required in addition implantation of mitral valve prostheses. 5 patients died 1-7 years after the operation from non-cardiac causes. Within the follow-up period no patients had relapse of endocarditis, and only one episode of recurrence endocarditis in an intravenous drug abuser was registered after 4 years.


CONCLUSIONS
An aortic homograft in combination with intravenous antibiotics is an excellent treatment of severe endocarditis in the aortic valve or an aortic valve prosthesis.
Foghsgaard
Signe
S
Gentofte Hospital, Thoraxkirurgisk Afdeling R, Hellerup.
Bruun
Niels Eske
NE
Kjaergård
Henrik Kåre
HK
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001011:Aorta / Q000637:transplantation*; D001021:Aortic Valve / Q000601:surgery; D001705:Bioprosthesis; D004697:Endocarditis, Bacterial / Q000382:microbiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents