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Valve replacement in active infective endocarditis

L D Wallace, D J Gillmer, S Vythilingum

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |June 20, 1981
    PubMed
    Summary
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    Emergency valve replacement is crucial for patients with active infective endocarditis (IE) facing critical conditions. Early surgery improves outcomes for these high-risk individuals.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Cardiac Surgery

    Background:

    • Infective endocarditis (IE) poses significant risks, often necessitating urgent intervention.
    • Valve replacement is a critical consideration in managing severe IE cases.

    Purpose of the Study:

    • To evaluate the effectiveness and outcomes of emergency valve replacement in patients with active infective endocarditis.
    • To identify key indications for immediate surgical intervention in IE.

    Main Methods:

    • Retrospective review of 30 patients who underwent valve replacement within 3 months of IE diagnosis.
    • Focus on 18 patients who underwent emergency surgery for active IE.

    Main Results:

    • Aortic valve involvement was universal; 67% had previously normal-appearing valves.

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  • Early mortality was 27.7% (5 deaths), primarily from circulatory failure.
  • Complications like prosthetic valve dehiscence were rare; prosthetic valve endocarditis did not occur.

    • Conclusions:

    • Early valve replacement is a viable and recommended option for critically ill IE patients.
    • Immediate surgery is indicated for IE with hemodynamic deterioration, uncontrolled infection, emboli, or conduction disturbances.