Acute endocarditis: Surgical treatment of aortic regurgitation and aortico-left ventricular discontinuity

Symbas, Panagiotis N.; Vlasis, S.E.; Zacharopoulos, L.; Lutz, Jerre F.

doi:10.1016/s0022-5223(19)39045-2

“…Several innovative surgical techniques have been developed to manage aortic root infection, such as patch closure of the abscess and in situ valve replacement, 14 translocation of the aortic valve and saphenous vein bypass grafts to the coronary arteries, 15 and…”

Section: Discussionmentioning

confidence: 99%

Aortic root replacement with Freestyle stentless valve for complex aortic root infection

Fukui

¹

,

Suehiro

²

,

Shibata

³

et al. 2003

The Journal of Thoracic and Cardiovascular Surgery

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ortic valve replacement in the presence of infectious endocarditis with an aortic annular abscess, aortic root destruction, and left ventricular-aortic discontinuity, remains a formidable surgical challenge. Early diagnosis and surgical intervention can be lifesaving. [1][2][3] Radical de´bridement of infected tissues and reconstruction of the left ventricular outflow tract are fundamental tenets of treatment. However, the choice of valve substitute remains one of the most contentious subjects in the management of this condition. Although several researchers 3-6 have reported success with homografts and autografts, prosthetic valve replacement remains the standard surgical approach. [7][8][9] Recently the porcine stentless bioprosthesis has gained favor as an aortic valve replacement because its hemodynamic performance is excellent and it has good midterm durability. [10][11][12] We have used this prosthesis in 5 patients with complex aortic root infection during the past 3 years, and that experience is the basis of this report.

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“…In 1981, Reitz successfully applied this technique to the treatment of prosthetic aortic valve endocarditis [16]. In 1982, Symbas combined aortic valve replacement with patch repair of a periannular abscess cavity [17]. In 1987, David and Feindel described techniques to reconstruct the mitral annulus with pericardium after debridement for PVE [18].…”

Section: Historical Notementioning

confidence: 99%

Prosthetic Valve Endocarditis

Ahmed¹,

Nashy²,

Eapen³

et al. 2018

Advanced Concepts in Endocarditis

0

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The management of infections of the cardiac structures-specifically native heart valvesremains a difficult clinical challenge. Patients often present with a systemic infection that is made worse by embolic complications, such as strokes, along with pathophysiologic sequelae of acute valvular dysfunction. The timing of interventions has a significant impact on short-and long-term outcomes. The challenges and management decisions are even more complex when the infection involves a prosthetic valve-as risks of reoperative cardiac surgery can be substantial. The goal of this chapter is to discuss the history of prosthetic valve endocarditis, review the current literature on the management of specific valvular involvement (i.e., aortic and/or mitral), and illustrate the challenging problems and outcomes that drive clinical decision making. While many of the indications for surgery are similar to those associated with native valve infections, there is increased risk with reoperative surgery, often difficulties in clearing infection due to prosthetic material being in place. Unfortunately, antibiotics alone are not always effective, and frequent communications between the cardiac surgeon and infectious disease physicians are often necessary to find the "sweet spot" to perform the surgery.

show abstract

“…In 1981, Reitz successfully applied this technique to the treatment of prosthetic aortic valve endocarditis [16]. In 1982, Symbas combined aortic valve replacement with patch repair of a periannular abscess cavity [17]. In 1987, David and Feindel described techniques to reconstruct the mitral annulus with pericardium after debridement for PVE [18].…”

Section: Historical Notementioning

confidence: 99%

Prosthetic Valve Endocarditis

&NA;

1987

The Pediatric Infectious Disease Journal

0

View full text Add to dashboard Cite

The management of infections of the cardiac structures-specifically native heart valvesremains a difficult clinical challenge. Patients often present with a systemic infection that is made worse by embolic complications, such as strokes, along with pathophysiologic sequelae of acute valvular dysfunction. The timing of interventions has a significant impact on short-and long-term outcomes. The challenges and management decisions are even more complex when the infection involves a prosthetic valve-as risks of reoperative cardiac surgery can be substantial. The goal of this chapter is to discuss the history of prosthetic valve endocarditis, review the current literature on the management of specific valvular involvement (i.e., aortic and/or mitral), and illustrate the challenging problems and outcomes that drive clinical decision making. While many of the indications for surgery are similar to those associated with native valve infections, there is increased risk with reoperative surgery, often difficulties in clearing infection due to prosthetic material being in place. Unfortunately, antibiotics alone are not always effective, and frequent communications between the cardiac surgeon and infectious disease physicians are often necessary to find the "sweet spot" to perform the surgery.

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Acute endocarditis: Surgical treatment of aortic regurgitation and aortico-left ventricular discontinuity

Cited by 47 publications

References 11 publications

Aortic root replacement with Freestyle stentless valve for complex aortic root infection

Aortic root replacement with Freestyle stentless valve for complex aortic root infection

Prosthetic Valve Endocarditis

Prosthetic Valve Endocarditis

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