Experience with surgical management of primary infective endocarditis: A collected review of 139 patients

Infective endocarditis at autopsy in Northern India. A study of 120 cases.

“…Destructive lesions are therefore far commoner on previously normal valves (the "primary" infective endocarditis). Cuspal destruction has been reported to occur in 60 to 92% of such cases.16), 22) Microbiological data with us were available in only 28 of the 120 cases and lends support to an earlier report from this Institute23) and to publications in the literature that the pathogenic staphylococci are more frequently the cause of infective endocarditis.14) Finally, the route of infection in our material is quite different from the Western experience.…”

Two-stage replacement of tricuspid valve in active endocarditis.

“…Surgical intervention was used only for patients with haemodynamic failure after healed endocarditis (Yeh et al, 1964), until Wallace et al (1965 for the first time operated during the active stage of endocarditis when conservative treatment had failed. Since then several similar reports have been published (Strandell et al, 1969;Manhas et al, 1972;Graham et al, 1973;Black et al, 1974). The favourable results tally with the well-known fact that the elimination of infected foci is important for the successful treatment of septicaemia.…”

“…Valve replacement during active endocarditis is not always successful, and there are reports of paraprosthetic endocarditis and failure of sutures (Manhas et al, 1972). Consequently, a decision on surgical intervention must not be premature, and should only be undertaken when antibiotic treatment has been shown to be ineffective.…”

“…Valve replacement during the active stage of endocarditis is now an accepted form of treatment in many places (Strandell et al, 1969;Manhas et al, 1972;Graham et al, 1973;Black et al, 1974), but not in all. Good results have been obtained in many cases of tricuspid valve endocarditis by means of valve resection alone (Arbulu et al, 1973;Graham et al, 1973, Michl et al, 1973 or with the insertion of an artificial valve at a second operation (Arbulu et al, 1973;Simberkoff et al, 1974).…”

Cirurgia conservadora de próteses aórtica e mitral na endocardite infecciosa

“…A EI em próteses valvares é uma complicação de alta morbimortalidade, não apresentando, em geral, boa resposta à antibioticoterapia, sendo tratada classicamente com cirurgia de substituição das próteses (1) . Os primeiros casos de tratamento cirúrgico de EI valvar datam da déca-da de 1960 (2) , em que era relatada a possibilidade de preservação das valvas (3)(4)(5) , principalmente quando acometia um pequeno segmento das mesmas (6,7) .…”