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Infective endocarditis. Surgical therapy
Luís Sérgio de Moura Fragomeni1, Fabiano Fernandes Vieira, Júlio Cesar de Mello Bajerski
1Hospital São Vicente de Paulo, Universidade de Passo Fundo, RS, Brazil. fragomeni@annex.com.br
Objective:
To assess the major causes of surgical morbidity and mortality in patients with infective endocarditis operated upon in a regional cardiology center.
Methods:
Thirty-four patients underwent surgical treatment for infective endocarditis. Their ages ranged from 20 to 68 years (mean of 40.6) and 79% were males. Their NYHA functional classes were as follows: IV - 19 (55.8%) patients; III - 12 (35.2%) patients; II - 3 (8.8%) patients. Blood cultures were positive in only 32% of the cases. Eight patients had already undergone previous cardiac surgery, whose major indication (82.3%) was heart failure refractory to clinical treatment.
Results:
Four (11.7%) patients died at the hospital. Follow-up was complete in 26 (86%) patients. Five (14.7%) patients died later, 12, 36, 48, 60, and 89 months after hospital discharge. Of the 21 patients being currently followed up, 1 is in NYHA functional class III, and 5 in NYHA functional class II.
Conclusion:
A high degree of clinical suspicion, at an early diagnosis, and indication of surgical treatment prior to deterioration of left ventricular function and installation of generalized sepsis may improve prognosis.