[Surgery for bacterial endocarditis: retrospective study of 32 patients].
BACKGROUND
Surgery for active endocarditis is indicated in cases of congestive heart failure (CHF), persistent sepsis, systemic embolization and paravalvular involvement.


OBJECTIVE
To assess and report the long term results of surgery in adult patients.


METHODS
Retrospective review of clinical records and operative procedures of 32 patients aged 43+/- 13 years (28 women) subjected to reparative surgery for complications of endocarditis between 1993 to 2005.


RESULTS
In 25% of cases, endocarditis presented as a prolonged sepsis syndrome and in 31% as a CHF or both. The causative bacteria was Gram (+) in 53% and blood cultures were negative in 47%. Preoperative echocardiography showed vegetations in 56% of cases. An annular abscess, aortic valve rupture and bicuspid valve, was observed in 13% of patients. Post operative mortality was due to persistent sepsis and multi-organic dysfunction in 16%. Mean long term follow up was 43.8+/-47.2 months. Actuarial survival was 78% at 146 months.


CONCLUSIONS
Surgical management of active endocarditis provides a good symptomatic recovery, with an excellent long term actuarial survival.
Bahamondes
Juan Carlos
JC
Cirugía Cardiovascular, Hospital Regional de Temuco, Temuco, Chile. jcbahamo@ufro.cl
Merino S
Gustavo
G
Silva V
Abelardo
A
Salman A
Juan
J
Redel S
Iván
I
Droguett G
Jean Pierre
JP
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000382:microbiology / Q000601:surgery*; D002677:Chile / Q000453:epidemiology; D004697:Endocarditis, Bacterial / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000382:microbiology / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D018805:Sepsis / Q000401:mortality / Q000601:surgery; D016896:Treatment Outcome