[Endocarditis after extracorporeal circulation surgery]

Between January, 1976 and April 1988, 1279 patients underwent open-heart operation in Ren Ji Hospital. Thirty three patients were complicated by infective endocarditis postoperatively, an incidence of 2.58%. Medical treatment was carried out in 29 cases and thirteen were cured. In another three patients of valve prosthetic endocarditis, replacement of prosthetic valve was necessary for their cure. In our series, Gram negative bacilli had been proved by blood culture, autopsy and arterial thrombi in thirteen patients and candida in four, mixed infection in five and staphylococcus aureus in only one case. One should not rely on positive blood culture for the diagnosis. Echocardiographic studies are helpful to early diagnosis and proper treatment. The presence of vegetation or signs of prosthetic valve failure are strong indication for reoperation. In prevention, in addition to strict aseptic technic in the operating room, special emphasis should be focused on the preventive administration of sensitive antibiotics against hospital borne pathogens. All indwelling catheters in arteries and veins, tracheal tubes and urethral catheters should be removed after 72 hours. Efforts to prevent infection after reoperation are important measures for the prevention of infective endocarditis after open-heart operation.