Surgical Treatment Of Inrective Endocarditis

ObjectiveInfective endocarditis (IE) is a serious heart disease, which will lead to inadequate cardiac function and often damages the heart valves. Without the efficient treatment, the consequences are of special serious. This project aims to analyze the clinical experience of surgical treatment of infective endocarditis and discusses the surgical treatment of infective endocarditis and prognosis of surgical treatment and relevant clinical features of IE.MethodsThe surgical group include43patients with IE by surgical treatment from Jan.2000to Jan.2011. Male30cases, female13cases, aged form9to68years old. In this surgical group, patients with congenital heart is18cases, in which patients with bicuspid aortic valve is7cases and patients combined with a ventricular septal defect (VSD) is7cases. Twenty-one microbiology examination is position. Patients with valve disease are involving43cases, involving the aortic valve are involving16cases, mitral valve14cases, double valve are involving the10cases, the pulmonary valve are involving2cases, tricuspid valve are involving1cases. Patients with cerebral embolism is2cases. Before surgery, The diameter of left heart end-diastolic is44to91mm, average (63±12) mm.All patients were treated with surgical treatment bypass (CPB), anesthesia, superior and inferior vena cava cannulas were inserted respectively or single-tube inserted in right atrial appendage, then established CPB, cold blood cardioplegia or HTK solution was used for myocardial preservation. Through the aortic root or the right atrium incision, heart is detected.Remove vegetations; iodine v tampon disinfection and saline water is rinsed repeatedly heart chamber. Heart valve is formed or replaced, and congenital heart acquire surgical treatment at the same time. Then patients return to the Intensive Care Unit, in which antibiotics intravenously is given.ResultsNo patient of postoperation death (in-hospital within35days). The patient with Cerebral Embolism is1after surgery. After the active treatment, the patients are discharged from hospital.It is the Reasons that vegetations fall off. One appear completely heart atrioventricular block and be implanted with permanent pacemaker. All patients were followed up form3to24months, an average of12.4months, no late death. Heart function (New York Heart Association, NYHA) classification:36cases of those are I level,7cases are level. Left heart end-diastolic diameter40～72mm, average (54±6) mm, and the comparative differences have statistically significant (P<0.05).SPSS13.0software was used for statistical processing and analysis, measurement data were indicated by、x±s," t test " was used for statistical analysis. P<0.05was considered that difference was statistically significant.Conclusions (1) Surgical resection is the ideal treatment of infective endocarditis with satisfactory effect.(2)80%of endocarditis is caused by streptococcus and staphylococcus aureus, so we should choose effective antibiotics.(3) Cardiac function in patients is severe damaged, so when The patients have anti-infection treatment, at the same time improving cardiac function is very important. Choose the right operation time, Treatment effect is satisfactory.(4) Many infective endocarditis will result from congenital cardiac anomaly basis, so it is necessary to treat congenital cardiac of slight symptom, in order to reduce the occurrence of infective endocarditis(5) Aortic valve and mitral valve disease easily. Vegetations fall off can cause cerebral embolism.