title: [Surgery for Infective Endocarditis Involving Valve Annulus].
abstract: Surgical treatment for isolated infective endocarditis( IE) has been improving over the last 2 decades. However, surgery for complicated IE such as disruption of paravalvular structure remains a challenge. The aim of this retrospective study is to evaluate our surgical results for IE with paravalvular structural disruption. From January 2002 to March 2015, we performed cardiac surgery for 68 patients who suffered from IE. Thirteen patients had paravalvular abscess and fistula. Valve disruptions were seen in aortic valve in 10 patients [2 fistulas from right coronary cuspid to right atrium or ventricle, 3 abscess formation from right coronary cuspid to interventricular septum, 1 abscess formation from left coronary cuspid to anterior mitral leaflet, 1 left ventricle to right atrium communication from non-coronary cuspid (NCC), 2 abscess formation under NCC and 1 circular annulas infection]. Mitral valve involvement was found in 2 patients [1 posterior mitral leaflet (PML) infection and submitral abscess infiltrating to annula calcification and 1 PML infection with submitral abscess]. One patient who had tricuspid valve involvement had giant vegetation from tricuspid to pulmonary valve through right ventricular outflow tract. Radical debridement of infected tissue and reconstruction using allograft, artificial valve and conduit were performed in all cases.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Daitoku
authors.forename: Kaoru
authors.initials: K
authors.lastname: Hattori
authors.forename: Wakako
authors.initials: W
authors.lastname: Fukuda
authors.forename: Masahito
authors.initials: M
authors.lastname: Minakawa
authors.forename: Ikuo
authors.initials: I
authors.lastname: Fukuda
mesh_terms: D000328:Adult; D000368:Aged; D058385:Cardiac Valve Annuloplasty; D004697:Endocarditis, Bacterial / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D006351:Heart Valves / Q000293:injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies