Surgical Aspects of Infective Endocarditis with Focus on the Aortic Root

Abstract

Infective endocarditis is an uncommon disease carrying a mortality between 10% and 25%. The mitral and aortic valves are involved between 34-42% and 36-50% respectively. Early and aggressive treatment is mandatory, this impacts on early and long-term outcomes. A multi-disciplinary team approach is currently accepted as standard of practice. Approximately half of the patients require cardiac surgery as a part of the treatment. In case of extravalvular spread of infection, persistent sepsis, multiple embolic events despite appropriate antibiotic therapy, acute or worsening conduction abnormalities or heart failure, urgent surgery must be considered. When the infection involves the aortic root, a radical approach is preferred. As we expected, prosthetic valve endocarditis has worst outcomes, particularly related to the higher mortality in reoperations.

A pilot study examining the safety and effectiveness of 8-weeks of early cardiac rehabilitation on physical function and psychological well-being in patients following aortic root replacement

“…This technique is commonly performed on the bicuspid aortic valve due to a congenital abnormality of the aortic root affecting 0.5 to 2% of the general population [1]. The vast majority of procedures undertaken involves the replacement of the aortic root with a mechanical valved conduit [2,3]. The mechanical valve is rarely used in patients over 70 years of age; in older populations, the biological valve has been shown to be more effective [1].…”