Acute endocarditis: surgical treatment of aortic regurgitation and aortico--left ventricular discontinuity

The clinical course of five patients with acute endocarditis resulting in aortic regurgitation and aortico--left ventricular discontinuity was reviewed. All five patients were operated upon less than 6 weeks after the onset of the antibiotic therapy. Aortic valve replacement and repair of the left ventricular discontinuity were done successfully in all five patients. The repair was accomplished in two patients primarily, with interrupted horizontal pledget-supported sutures placed through the left ventricular and aortic walls and through the ring of a valve prosthesis. In the remaining three patients, the repair was performed with the interposition of a Dacron patch between the left ventricle and the aorta, and the valve prosthesis was then sutured to the graft and to the remaining native aortic anulus. The latter technique has many attractive features for the repair of left ventricular discontinuity when there exists a large gap between the aorta and left ventricle.