Infective endocarditis: surgical therapy

Abstract

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.

Early results for active infective endocarditis

“…The most characteristic finding in our study was the high frequency of negative blood culture 77(76.2%). Our results were in accordance with previous reports from the developing world [ 5 , 18 , 19 , 20 , 28 ]. In contrast, in series from western countries, blood cultures were found negative in 5-15% of IE [ 23 ].…”

“…In developed countries there is a decrease in RHD and increase in degenerative heart disease.According to the NYHA functional class classification, most of patients 81(80.2%) were in class III-IV on the admission to the hospital. Similar data were observed in other investigations [ 5 , 17 , 24 , 26 ]. It is difficult to determine the real prevalence of IE in the general population because this disease is continuously changing.In recent retrospective study conducted in 9 French ICU during an 11- year period, Duval et al [ 27 ] found the annual incidence of IE at the beginning of the 21 st century is around 33 case per million habitants.…”

“…Our study investigated a selected group of patients suffering from AIE who underwent valve surgery.In this study, patients are mostly young (mean age 40.5 ± 12.5 years) with 49 (48.5%) below 40 years of age. This findings are similar to that reported by Fragomeni [ 5 ], but higher when compared to recent Indian studies [ 17 , 18 ] 27±12.7years and 23.5 years respectively. This age is similar to that reported in recent clinical epidemiologic study conducted in Laos' speoplein democratic republic in Vietnam (25 years) [ 19 ].…”

“…Guidelines for prevention and management of IE recommend early heart surgery [ 3 , 4 ], because those patients are still initially managed in community hospital with no tools for diagnosis such as laboratory investigations, imaging techniques. They are frequently referred to specialized centers in an advanced stage with severe valvular damage and hemodynamic impairment [ 5 ]. Despite a better knowledge of predisposing factors [ 6 , 7 ] refinements in diagnostic techniques, availability of new antibiotics [ 8 ] and a progress in surgical therapy, IE is associated with substantial morbidity and mortality [ 9 , 10 ].…”

Clinical, Microbiological, and Imaging Characteristics of Infective Endocarditis in Latin America: A Systematic Review

“…One study comprised 2 reports, but both were included since one reported data on clinical and imaging characteristics (Casabe et al, 1996b) and the other reported data on microorganisms and further clinical manifestations (Casabe et al, 1996a). We treated this study as one throughout the review leading to 44 studies(Allende González et al, 2020;Avellana et al, 2018;Bahamondes et al, 2008;Bezerra et al, 2020;Burgos et al, 2019;Casabe et al, 1996b;Corral et al, 1993;Cremona et al, 2007;Damasco et al, 2014;Ediap et al, 2017;Ferreiros et al, 2006;Flores et al, 2017;Fragomeni et al, 2003;Fránquiz Cuéllar and Alvarez Ozambela, 1986;Holanda et al, 2015;Jacob Filho et al, 1988;Jáuregui Camargo et al, 1997;Kaiser et al, 1984;Leyva Quert et al, 2009;Marino et al, 2014;Merello et al, 2019;Monteiro et al, 2017;Murdoch et al, 2009;Negrín Expósito et al, 2003;Nieto et al, 1985;Olaya-Sanchez et al, 2019;de Oliveira et al, 2018;Ortiz et al, 1983;Oyonarte G et al, 2003;Pérez Zerpa et al, 2020;Pinheiro et al, 2018;Pivatto Júnior et al, 2020;Popilovsky et al, 2014;Ris et al, 2019;Romero Flecha and Aveiro Figueredo, 2020;Saito et al, 2014;Siciliano et al, 2014a…”