Surgical Management of Left Ventricular–Aortic Discontinuity Complicating Bacterial Endocarditis

Frantz, Paul T.; Murray, Gordon F.; Wilcox, Benson R.

doi:10.1016/s0003-4975(10)61617-7

Cited by 91 publications

(10 citation statements)

References 46 publications

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“…Debridement of all infected and devitalised tissue is the mainstay of the surgical treatment of aortic root abscess. Several different surgical techniques have been advocated, including closure of the defect with a patch,2 22 23 implantation of a composite prosthetic valve conduit,3 24 aggressive debridement of the abscess cavity and surrounding tissue with reconstruction of the left ventricular outflow tract with autologous pericardium,25 translocation of the aortic valve,4 26 27 and extra-anatomical bypass of the aortic root 28. The feature common to all these operations is the use of synthetic material.…”

Section: Surgerymentioning

confidence: 99%

Aortic root abscess

Brecker

Pepper²,

Eykyn

1999

Heart

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Section: Surgerymentioning

confidence: 99%

Aortic root abscess

Brecker

Pepper²,

Eykyn

1999

Heart

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“…REITZ et al (28) utilizaram tubo valvulado, fechando os óstios e revascularizando com pontes de veia safena. FRANTZ et al (29) usaram técnica semelhante, mas com reimplante dos óstios.…”

Section: Resultsunclassified

Endocardite infecciosa: 12 anos de tratamento cirúrgico

Arnoni¹,

Neto²,

Arnoni³

et al. 2000

Rev Bras Cir Cardiovasc

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A endocardite é uma doença que vem sofrendo modificações desde sua descoberta, tanto na concepção diagnostica, como na detecção de seus agentes causadores, passando pelos métodos diagnósticos com a evolução dos ecocardiógrafos e terminando no tratamento clínico ou cirúrgico.Arnoni A S, Castro Neto J, Arnoni R T, Almeida A F S, Abdulmassih Neto C, Dinkhuysen J J, Issa M, Chaccur P, Paulista P P - Resultados: O estudo microbiológico evidenciou maior prevalência de infecção por Streptococcus viridans e Staphilococcus aureus. A operação realizada nos portadores de endocardite infecciosa em valva nativa propiciou a conservação da valva em 3 pacientes do grupo mitral e em 1 do grupo aórtico; nos demais pacientes empregaram-se próteses (a maioria metálica em aórticos e biológica em mitrais). As reoperações foram freqüentes, tendo pacientes com até quarta operação. A lesão congênita responsável pela maioria dos casos foi a comunicação interventricular (3 casos) e 4 pacientes apresentavam a endocardite em eletrodo de marcapasso. A mortalidade global foi de 16,3%, com maior incidência em portadores de prótese mitral e aórtica submetidos a reoperação. A presença de abscesso como complicação da endocardite infecciosa verificou-se em 18,2% dos pacientes, utilizando-se pericárdio bovino na reconstrução da maioria, com mortalidade de 17,2%.Conclusão: Concluímos que o tratamento cirúrgico da endocardite infecciosa representa um desafio para o cirurgião, apesar de todo o progresso adicionado ao arsenal diagnóstico e terapêutico desta patologia. DESCRITORES: Doenças das valvas cardíacas, cirurgia. Implante de prótese de valva, mortalidade. Implante de prótese de valva, resultado de tratamento. Implante de prótese de valva, análise de sobrevivência. Endocardite, cirurgia. Endocardite, resultado de tratamento.RBCCV 44205-517

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“…The mitral annulus may be reconstructed with autologous pericardium after debridement, as described by David and Feindel [62]. If the posterior mitral annular region requires reconstruction, this may be done with pericardium as well [15]. If necessary, the new mitral prosthesis may be translocated onto either the atrial or ventricular side of the annulus.…”

Section: Mitral Prosthetic Valve Endocarditismentioning

confidence: 99%

Prosthetic Valve Endocarditis

Ahmed¹,

Nashy²,

Eapen³

et al. 2018

Advanced Concepts in Endocarditis

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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.

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Surgical Management of Left Ventricular–Aortic Discontinuity Complicating Bacterial Endocarditis

Cited by 91 publications

References 46 publications

Aortic root abscess

Aortic root abscess

Endocardite infecciosa: 12 anos de tratamento cirúrgico

Prosthetic Valve Endocarditis

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