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Early valve replacement in active infective endocarditis.

L C Pelletier, R Baillot, P Auger

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |July 1, 1984
    PubMed
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    Early valve replacement surgery significantly improves survival for patients with infective endocarditis. This approach offers a low operative mortality and morbidity, reducing major complications of this serious heart infection.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Cardiac Surgery

    Background:

    • Infective endocarditis (IE) carries a high mortality rate.
    • Early surgical intervention may prevent major IE complications.

    Purpose of the Study:

    • To evaluate the outcomes of early valve replacement in patients with infective endocarditis.
    • To assess the operative mortality and morbidity associated with this surgical approach.

    Main Methods:

    • Retrospective study of 50 patients with IE treated between 1977 and 1982.
    • 20 patients underwent early valve replacement; 30 were treated non-surgically.
    • Analysis of pathogens, prosthetic vs. native valve involvement, and follow-up outcomes.

    Main Results:

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    • Early valve replacement in 20 patients showed low operative mortality (15% early, 5% late deaths).
    • No recurrence of infection on prosthetic valves, though one reoperation was needed for dehiscence.
    • All survivors demonstrated improved functional capacity (NYHA Class I/II) after 26 months follow-up.

    Conclusions:

    • Early valve replacement is a viable strategy for improving survival in infective endocarditis.
    • The procedure is associated with acceptable operative risks and good long-term functional outcomes.