Study On Related Factors Of Adjacent Valve Thickening After Infective Endocarditis

Objective: To explore the factors related to the thickening of adjacent valves after the operation of infective endocarditis,and to provide guidance for clinical work.Methods: In this study,the clinical data of patients with single tricuspid valve or aortic valve involved in infectious endocarditis treated by cardiac surgery in our hospital from 2011 to 2017 were selected and treated with prosthetic valve replacement in our department.A total of 59 patients with infective endocarditis,including 34 males and 25 females,aged from 32 to 79 years with an average age of(50.88±11.14)years,were enrolled in this study.The sex and age of the subjects were recorded.History of hypertension,diabetes and smoking,and sampling of venous blood to monitor total cholesterol,low density lipoprotein bile Sterol,high density lipoprotein cholesterol,triglyceride,lipoprotein,etc.They were divided into two groups according to different intraoperative valvular flushing fluid.Group A(n = 35)was treated with diluted 0.5% povidone iodine and saline for repeated flushing of),B group(n = 24),and group A(n = 24)was treated with saline alone.All the patients were infective endocarditis who underwent heart-related hand operation for the first time.Electrocardiogram was routinely performed before operation and chest CT,transthoracic cardiac color Doppler examination was performed.Patients included in the study were followed up for more than 2 years,followed up once a year by color Doppler echocardiography.Results: In this study,none of 59 patients died during and after operation,and the follow-up time was more than 2 years.No recurrence was found in all the patients within 6 months after operation,and no recurrence occurred during the follow-up.SPSS21.0 was used for statistical analysis.Sex,hypertension,diabetes mellitus,total cholesterol,high density lipoprotein cholesterol(HDL-C)between valvular thickening group and non-thickened valvular group were analyzed.There was no significant difference in low density lipoprotein cholesterol(P > 0.05).There was a significant difference in age between the two groups(54.45±13.41 Y than 45.86±7.62 Y,P<0.05).There was a significant difference in lipoprotein Lp(a)between the two groups.There was a statistical difference in(220.32±106.10mg/L than 157.51±93.31mg/L,P<0.05).The rush between the two groups.There’s a statistical difference in lotion,(P<0.05).Of all the patients studied,5 were re-operated on the adjacent valvular membrane,all of whom were treated with diluted 0.25% povidone iodine and physiological salt water for repeated flushing of perivalvular and endocardial cavities during the first operation.There was significant difference between the two groups(P < 0.05).Conclusion: The increase of age after infective endocarditis can cause the thickening of adjacent valves.The use of diluted 0.25% povidone iodine to rinse the perivalvular valve and endocardial cavity during the operation can increase the possibility of adjacent valve thickening.Therefore,repeated rinsing of valves with saline alone can effectively remove microorganisms around the valve and endocardium,prevent the recurrence of infective endocarditis,and avoid the second operation caused by injury to the endothelial cells of the valve.Compared with diluted 0.25% povidone iodine,the use of physiological salt water had a better prognosis,and to a certain extent,it provided a guiding meaning for the clinical use of povidone iodine.