Cardiac operations during active endocarditis

Jubair, Khalid Al; Fagih, Mohamed R. Al; Ashmeg, Abdullah; Belhaj, Miloud; Sawyer, W. A.

doi:10.1016/s0022-5223(19)34809-3

Cited by 50 publications

(8 citation statements)

References 16 publications

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“…In the first 60 days after surgery, Staphylococcus epidermidis, Staphylococcus aureus, the gram-negative bacilli, diphtheroids, and fungi are the most common causes of PVE 26 . The indications for the surgical treatment of infective endocarditis reported in the literature 27,28 are similar to those in our series and may be grouped as follows: severe and progressive heart failure refractory to clinical treatment; infection that could not be controlled with antimicrobial treatment; uncontrolled infection in a cardiac prosthesis, and systemic arterial embolisms. In regard to functional class, as reported by other authors [29][30][31] , most patients were in NYHA functional classes III and IV.…”

Section: Discussionsupporting

confidence: 74%

Infective endocarditis: surgical therapy

Fragomeni¹,

Vieira²,

Bajerski³

et al. 2003

Arq. Bras. Cardiol.

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Section: Discussionsupporting

confidence: 74%

Infective endocarditis: surgical therapy

Fragomeni¹,

Vieira²,

Bajerski³

et al. 2003

Arq. Bras. Cardiol.

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“…No re-infection developed in any of the patients who had early surgery, nor in any remaining patient who had surgery whilse still in the active phase of bacterial endocarditis. This finding agrees with another report 6 and contrasts with a 7% rate of re-infection reported elsewhere. 3 Re-infection with the same causative organ-ism occurred after cessation of treatment in 23% of patients who received medical therapy alone.…”

Section: Discussionsupporting

confidence: 92%

“…None of our patients developed paravalvar leaks after surgery. This compares well with the report of a very low incidence of 1/65 patients developing paravalvar leak, 6 and contrasts with other reports ranging between four to 3 1 % according to the timing of surgery. 7 The indications for, and timing of, surgery in bacterial endocarditis has, nonetheless, been controversial.…”

Section: Discussionsupporting

confidence: 74%

Endocarditis in the young

Jubair¹,

Yousef²,

Khan³

et al. 1994

Cardiol Young

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Between February 1980 and February 1992, 28 children (17 males and 11 females) were treated for endocarditis on congenital cardiac lesions, most commonly the mitral valve (32%). Their ages ranged between four months and 14 years (mean 8.2 years). The most common infecting organism (in 25% of patients) was Staphylococcus aureus. Patients were divided into two groups. In the first, made up of eight patients, cardiac surgery was undertaken within one week of the start of antibiotic therapy. The second group of 20 patients was further divided into a group of seven patients who underwent surgery during the initial, active stage of endocarditis because of failure of medical management and a group of 13 patients who initially received antibiotic therapy alone. In this last group, three infections with the same organism recurred within two months and surgical intervention was necessary in the active phase of the recurrence. Subsequently, surgery for “healed” endocarditis was undertaken in three more patients. Mortality in the 21 patients undergoing surgery was 19%—one of eight (12.5%) in those undergoing surgery within one week of starting treatment and two of 10 in the remaining patients. Overall, three patients (15%) died from those in whom surgery was not undertaken within one week of the start of treatment. There were also fewer pre- and postoperative complications as well as a lower mortality rate in those undergoing early surgery. We conclude that early surgical intervention, in our hands, is the most appropriate management for endocarditis in congenital cardiac lesions.

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“…5 ' 6 The disclosure of moderate or large vegetations by cross-sectional echocardiography is considered by some to be an indi-cation for surgery. 6 Intracardiac vegetations associated with active infection represent a serious management problem due to persistent sepsis, myocardial structural damage, and threat of embolization. Appropriate antibiotic therapy may control sepsis and result in resolution of the vegetations.…”

Section: Discussionmentioning

confidence: 99%