title: [Aortic infective endocarditis: Value of surgery. About 48 cases].
abstract: BACKGROUND
  Infective endocarditis (IE) is a serious disease whose prognosis depends on early management. Aortic location is characterized by its evolution toward myocardial failure and the high number of complications reasons for early surgery.
  
  
  OBJECTIVE
  To compare the short- and mid-terms results of surgery for aortic infective endocarditis (IE) in the active phase and the healed phase.
  
  
  METHODS
  We analyzed retrospectively the data of 48 consecutive patients operated for aortic infective endocarditis between January 2000 and January 2012. The data on operative mortality, morbidity and major cardiovascular events (mortality, recurrent endocarditis, reintervention, and stroke) were analyzed.
  
  
  RESULTS
  Twenty-three patients (48%) underwent surgery during the active phase (group I), 19 on native and 4 on prosthetic valves, and 25 patients (52%) were operated during healed endocarditis (group II) only on native valve. Mean age was 39 years (12-81) with a male predominance (83%). Rheumatic valvular disease was the main etiology of underlying valvular disease in both groups (85%). The clinical feature was dominated by signs of cardiogenic shock in group I and dyspnea exertion stage III-IV NYHA in group II. Streptococcus and Staphylococcus germs were most frequently encountered. Indication for surgery was heart failure in group I, it was related to the symptoms, the severity of valvular disease and its impact on the left ventricle in group II. An aortic valve replacement with a mechanical prosthesis was performed in the majority of cases (83%). Postoperative mortality concerned only one patient in group I. Twenty-one patients (44%) were followed for a mean of 30 months (1-72). One patient in group II died following cerebral hemorrhagic stroke related to accident with vitamin K antagonist. In both groups, there was an improvement in the functional class. No recurrence of endocarditis was noted in both groups during follow-up.
  
  
  CONCLUSIONS
  The prognosis of infective endocarditis of the aortic valve is severe due to the fast progression to heart failure. Early medical and surgical approach provides good results on morbidity and mortality in the short- and mid-terms.
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc. Electronic address: tribakmed@yahoo.fr.
authors: M
authors: M
authors: Tribak
authors: Service de cardiologie A, hôpital Ibn Sina, Rabat, Maroc.
authors: M
authors: M
authors: Konaté
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: A
authors: A
authors: Elhassani
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: L
authors: L
authors: Mahfoudi
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: I
authors: I
authors: Jaabari
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: F
authors: F
authors: Elkenassi
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: A
authors: A
authors: Boutayeb
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: F
authors: F
authors: Lachhab
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: J
authors: J
authors: Filal
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: A
authors: A
authors: Maghraoui
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: A
authors: A
authors: Bensouda
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: L
authors: L
authors: Marmade
authors: Service de chirurgie cardiovasculaire B, hôpital Ibn Sina, Rabat, Maroc.
authors: S
authors: S
authors: Moughil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D002648:Child; D004452:Echocardiography; D004696:Endocarditis / Q000601:surgery*; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult
keywords: Aortic valve; Endocardite infectieuse; Heart failure; Infective endocarditis; Insuffisance cardiaque; Recurrence; Remplacement valvulaire; Récidive; Valve aortique; Valvular replacement