[Infective endocarditis. Medicosurgical experience in a series of 137 patients]

We have reviewed our 1978 to 1987 experience in the treatment of 137 patients with 145 episodes of Infective Endocarditis. In 55 episodes the infection involved a valvular prosthesis. Positive blood cultures were obtained in 72.7%, with clear preeminence for staphylococcal organisms. Renal disfunction was associated in 41.8% of the cases and periprosthetic-leak in 40% of them. Eight patients died without surgery, five cases were cured by medical treatment alone, and 42 cases were operated, most of them because refractory heart failure. Surgical mortality was 15 cases (35.7%), with statistical significance within the early prosthetic valve endocarditis group, in which in turn was significantly greater the incidence of non-streptococcal germs, renal disfunction and periannular abscesses. The mean late follow-up was 47.6 months, including 88.8% of the surgical survivors, with a survival rate of 64.1%, being most of patients in a good functional status. In 90 episodes the infection involved a native valve, with about 40% of the cases in drug abusers. Positive blood cultures were obtained in 77.7% of the cases, with slight preeminence of staphylococcal germs. Renal dysfunction was associated in 16.6% of the cases. In 41 episodes were used only medical therapy, involving 30 of them the right side, with a death in this group. The treatment was surgical in 49 episodes, 45% of them in order to correct residual valve lesions.