Surgery of arterial embolism in patients with infective endocarditis

A total of 265 patients suffering from infective endocarditis (IE) were operated on at the Center of Cardiology and Cardiovascular Surgery. Of these, 20 patients presented with arterial embolism of the peripheral arteries of varying standing (from in-hospital episodes of embolism to 8 months). Embolism of the cerebral arteries was identified in 8 (3.0%) patients with IE. In 5 patients, an embolus was located in the orifice of the internal carotid artery. Three persons were diagnosed to have embolism of the intracranial arteries. Thromboembolism of the limb arteries was present in 12 (4.5%) cases. Active IE was diagnosed in 11 patients; in 9 cases, IE was in a stage of remission, Bivalvular mitralaortic disease was present in 4 patients; aortic disease was identified in 9 and mitral disease in 7 patients. In 3 patients with acute disorders of cerebral circulation arising from embolism of the carotid arteries and in 3 patients with progressive acute limb ischemia due to embolism of lower limb arteries, the operations were performed on an emergency basis. In these cases, two stage operations were undertaken. Five patients presenting with infective aneurysms of lower limb arteries and thromboembolism of the peripheral arteries with chronic lower limb artery ischemia underwent one stage operations. The first stage of operation consisted in resection of the infected vascular segment and an aneurysm, the second stage in correction of valvular heart disease. The outcomes of operations were regarded as satisfactory in all the cases. No complications or lethal outcomes were recorded in the postoperative period.