[Surgical treatment of infective endocarditis]

Since 1976, 37 patients have undergone valve replacement for infective endocarditis at our institute. Twenty patients required surgery during the active stage and 17 in the inactive stage. The former group consisted of 17 native and three prosthetic valve endocarditis, and all patients in the latter group had native valve endocarditis. Eighteen patients had AVRs, 15 had MVRs and four had DVRs. Congestive heart failure was the indication for surgery in 80% of the active and 100% of the inactive group. There were nine early deaths (45%) and one late death in the active group, and one early (6%) and one late death in the inactive group. Operative mortality in the active group, however, has recently been reduced to 30% for the 10 patients operated upon in the past two years. Two patients with active endocarditis were complicated by rupture of cerebral mycotic aneurysms postoperatively and resulted in one early and one late death, respectively. It is suggested that timely surgical intervention according to the hemodynamic state of the patients is essential in reducing early mortality in infective endocarditis. Attention should be paid to cerebral mycotic aneurysm as one of the problems affecting on postoperative mortality and morbidity.