Korean J Thorac Cardiovasc Surg.  2007 May;40(5):341-350.

Short Term and Midterm Surgical Results for Infective Endocarditis: Does Wide Debridement and Reconstruction Affect the Post Operative Mortality and Morbidity?

• Yie KS
• Na CY
• Oh SS
• Kim JH
• Shinn SH
• Kim JH
• Kim SC

Abstract

BACKGROUND: We present here the early and midterm surgical results for infective endocarditis and we especially focus on the effect of aggressive reconstruction or root implantation after wide debridement. MATERIAL AND METHOD: Between January 1995 and Jun 2006, we enrolled 79 adult infective endocarditis patients who underwent surgical treatment. There were 63 and 16 native and prosthetic valve endocarditis cases, respectively. They included 27 cases of culture negative endocarditis. With performing valve replacement or repair, 28 of the patient underwent a more aggressive surgical option, for example, aortic root replacement or reconstruction, or heart base reconstruction etc. RESULT: There were statistical relationships between the in-hospital mortality and staphylococcal infection, urgent-based operation and operation during the active phase of endocarditis. Wide debridement and aggressive reconstruction were not related to either the post operative mortality or the early morbidity. Culture negative endocarditis was not related to the postoperative mortality and morbidity.
CONCLUSION
Physicians must pay attention to patients' medical treatment during the preoperative period of the infective endocarditis. If surgery is considered for treating infective endocarditis, it should be performed before the downhill course of the disease so that the surgical outcome is improved. Wide debridement and more aggressive reconstruction are also warranted.

Keyword

Endocarditis; Valves; Infection; Surgery for acquired cardiovascular disease

MeSH Terms

Adult
Debridement*
Endocarditis*
Heart
Hospital Mortality
Humans
Mortality*
Preoperative Period
Staphylococcal Infections