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Early surgery for active infective endocarditis.

Y Sasaki1, S Suehiro, T Shibata

  • 1Second Department of Surgery, Osaka City University Medical School, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|October 13, 2000
PubMed
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Early surgery for infective endocarditis is recommended for patients with worsening heart function or large vegetations. This study reviewed 26 patients, showing low mortality and no recurrence after valve replacement.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Infectious Diseases

Background:

  • The optimal timing for surgical intervention in active infective endocarditis is a subject of ongoing debate.
  • This study retrospectively analyzed patients with active infective native-valve endocarditis who underwent surgical treatment.

Purpose of the Study:

  • To evaluate the outcomes of surgical intervention for active infective native-valve endocarditis.
  • To identify factors influencing operative mortality and long-term prognosis.

Main Methods:

  • Review of 26 patients undergoing surgery for active infective native-valve endocarditis between April 1992 and December 1998.
  • Analysis of patient demographics, affected valves, causative microorganisms, preoperative functional class, operative indications, and surgical procedures.

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  • Assessment of operative mortality and long-term follow-up data for survivors.

    • Main Results:

    • The most common microorganisms were streptococcal species, with aortic and mitral valve involvement frequent.
    • Seventy-seven percent of patients presented with New York Heart Association functional class III or IV.
    • Operative mortality was 7.8% (2 patients), with deaths linked to deep cardiac tissue and cerebral artery infection extension.

    Conclusions:

    • Early surgical intervention is advised for patients with active infective endocarditis experiencing rapid cardiac deterioration.
    • Echocardiographic findings of vegetation larger than 1 cm are a significant indication for surgery.
    • No late deaths or recurrence of infective endocarditis were observed in survivors after a mean follow-up of 33 months.