Surgical Treatment Of Congenital Cardiac Disorder With Infective Endocarditis: A Series Of 26 Cases

Objective:to conclude the clinical experience of surgical treatment of infective endocartitis with congenital cardiac disorder. Method:to summarize retrospectively the 26 IE patients underwent heart operation From September, 2002, to April 2009. 19 cases of man(19/26,73.0 percent),7 cases of women(7/26, 26.9percent).7 to 43 years old, average age(23.12±4.53)years old .10 days to 2 months of case history of infective endocarditis ,average case history(24.24±4.16)days. Ventricular septal defect of five cases, Patent ductus arteriosus of one case, Ventricular septal defect with Patent ductus arteriolus of two cases, Aortic vavle of bilobed flap of 13 cases,tetralogy of fallot of one case,Rupture of aneurysm of aortic sinus of two cases,Atrial septal defect with Rupture of aneurysm of aortic sinus of one case,Patent foramen ovale with Ebstein's anomaly of one case, all the cases underwent intrvenouse antibiotic treatment for infection ,cardiotonic and diuretic treatment for cardiac disfunction preoperatively, and underwent trachea cannula, balanced anesthesia and cardiopulmonary bypass during the operation. Result:the early-death occurred in one case. The early death-rate is 3.8 percent. Cause of death: septic shock caused by postoperative infection of incision and mediastinum. Early complications include:Ⅰdegree of Atrioventricular conduction block in two cases, Infection of incision, pneumonedema, cerebral hemorrhage ,Prosthetic valve endocarditis in one case respectively,all with fully recovery, 25 cases were discharged after the operation and subsequent antibiotic,cardiotonic and diuretic treatment with the cardiac function recoverd,body temperature and hemogram became normal, follow-up visit lasted for 2-24 months with no-recurrence. Conclusion:the proactive surgical operation with concurrent antibiotic treatment,the handling of the appropriate time for operation, the method of operation and selecting the appropriate antibiotics are essential for improving the rate of recovery.