[Effectiveness of combined treatment of infective endocarditis]

The purpose of the study was to develop and perfect complex therapy of modern infective endocarditis (IE). Ten-year experience in clinical diagnostics of 240 patients with acute, subacute, and lingering IE was summarized; the effectiveness of their treatment was evaluated. The features of modern IE were acute and subacute course of the disease with the involvement of aortal (37.8% of cases), tricuspid (16.8%), mitral (15.2%) valve, and septicemia, caused by highly virulent microflora (staphylococci--51% of cases; gram-negative bacteria--13%; fungi--5%). The clinical manifestations of modern IE included toxic infectious syndrome (24% of cases), heart failure (21%), symptoms of complications (16%), central hemodynamics disturbances (12%), and splenomegaly (8%). The treatment included antibacterial, pathogenetic, and symptomatic therapy, as well as extracorporal hemocorrection and cardiosurgery. Analysis of the results of surgical treatment of 140 IE patients allowed development of indications for valve prosthesis.