Surgical Treatment Of 82 Cases With Infective Endocarditis

Objective:To summarize the clinical features of 82 patients with moderate above-valve insufficiency caused by infective endocarditis(IE)in our department and to investigate the operation time,method and outcome of these patients.Methods:In January 2012 to December 2017,we consecutively collected clinical data of82 patients with valve-infected endocarditis who underwent cardiac vascular surgery in our hospital.There were 60 males and 22 females;aged 9-73(46.4±13.8)years old.74 cases have past histories of valvular heart disease,6 cases have congenital heart disease complicated with valve disease,2 cases have valve leakage after valve replacement.5 cases were complicated acute cerebral infarction,1 case was complicated coronary embolism,1 case preoperatively pregnant.Blood cultures were positive in 28 cases.Cardiac ultrasonography in all cases revealed changes in the valve or endocardial vegetation;rupture of the tendon cord with prosthetic valve;perforation of the valve and leakage around the valve.NYHA classification were used to evaluate preoperative cardiac function: class I in 12 patients;class II in 23 patients;class III in 35 patients and class IV in 12 patients.All the patients underwent surgery.All clinic data were recorded.Results:After operation,81 cases were cured and discharged,1 died,and the average length in hospital was 22.1 days.The average time of Follow-up were 30.1 months,ranged from 1 month to 72 months.Echocardiography showed that the function of vale or prosthetic valve are well.Cardiac function of 52 cases restore to class I after surgery and 23 cases to class II.Postoperative blood cultures were negative.and culture of infected valve was positive in 15 cases.The left ventricular ejection fraction was(55.5±6.6)%,the shortening rate of left ventricular short axis was(29.0±4.1)%,and the left ventricular end-diastolic diameter was(59.5±9.8)mm,which were significantly different from the preoperative correlation index(P<0.05).Conclusions:(1)Surgical treatment of valvular infective endocarditis is effective.The average time of Follow-up were 30.1 months,ranged from 1 month to 72 months.and the efficacy of the later period needs further follow-up observation.(2)The timing of surgery depends on the individual assessment of the patient’s condition;rational application of antibiotics,correct grasp of the timing of surgery,and reasonable choice of surgical approach are the keys to good efficacy.