Role of Surgery in Infective Endocarditis

Abstract

ABSTRACT. One‐hundred‐and‐thirteen patients with endocarditis and valvular insufficiency were studied retrospectively with special regard to indications for operation and the optimum time for cardiac valve surgery. Thirty patients (group I) had acute, 63 (group II) subacute and 20 (group III) prosthetic valve endocarditis. Group I: Eleven patients underwent surgery in the acute stage, 8 while bacteremic; 5 of the latter died perioperatively. Of the 19 patients treated medically, 16 died. Group II: All patients underwent operation in a bacteria‐free state. The mortality was 5%. Group III: Eight patients had early (<60 days postoperatively) and 12 late endocarditis. Total mortality was 40% (71 % early and 25% late mortality). Ten patients underwent reoperation, with a mortality of 20%, compared with 60% in the medically treated group. The results support the indication for early operation in acute endocarditis with progressive cardiac failure and renal failure and prosthetic valve endocarditis, even during bacteremia.

Surgical management for active infective endocarditis: A single hospital 10 years experience

“…Since recurrent endocarditis is a dreadful complication and targeted postoperative antibiotic treatment for more than 4 weeks carries a better prognosis, according to recent reports 4,5 , the determination of microorganisms could affect early and late outcomes after surgery. Because of the heterogeneity of the clinical and pathologic make up of patients undergoing surgical treatment for active endocarditis, operative mortality ranges widely between 3.8 and 22% [6][7][8][9][10][11][12][13][14][15][16] congestive heart failure, cerebral or coronary embolism, prosthetic valve infection, recurrent events, and failed antibiotic therapy.…”