Surgieal Treatment Of Infective Endoearditis

Objectives: To summarize the clinical characteristic, Pathogenicmicroorganism, echocardiography, therapy and prognostic factors of26Patients with infective endocarditic (IE), to improve the early diagnosis andtreatment.Methods: General information, underlying heart diseases, types ofpathogens, drug susceptibility test results, echocardiogram of26IE cases ofsurgically treated from1994to2013were retrospectively analyzed. Beforeoperation, antibiotic was administed to all Patients. Blood culture was taken inall cases,14of whom were positive, mainly caused by staphylococcus. Allcases were operated under cardiopulmonary by Pass to Valve replacement orVentricular sepals defect repair. All cases were take care of in ICU andcontinued to be treated with antibiotics for4～6weeks after surgery.Results：1Most of the patients had underlying heart diseases. The rate ofcongenital heart disease with IE has increased year by year.2From the clinical dates, risk factors for such as intravenous drugaddiction and interventional therapy played an important role.3Most of clinical symptoms of patients with fever as starting symptomsassociated with interleukin increased.At the same time, most less than39℃.4Patients with atypical infective endocarditis were more and more.Patients with hypersplenotrophy and embolization were not common. Osler’snode is also rarely.5The result of blood cultures were Streptococcus and staphylococcus(50%). Some of the patients had infection due to atypical pathogenic bacteriasuch as Streptococcus mitis.6Vegetation was found in15cases, including aortic vegetations (40%),mitral valve vegetations (13%), tricuspid valve vegetations (20%), pulmonic valve vegetations(20%),and left atrium vegetations(7%) by echocardiography.730%had been administrated medical treatment including antimicrobialprimarily.18cases were administrated surgical treatment in which8cases ofValve replacement,5cases of Ventricular sepals defect repair,1cases of Sinusaneurysm rupture repair,3cases of Ligation of artery catheter,1cases of Seal ofartery catheter.8All patients’ condition was improved. The average days of in hospitalwere54without abnormal body temperature or organ infection. The result ofultrasonic cardiogram and blood culture was normal. Every patient was curewithout intraoperative death or early death after surgery and cardiac functionrecovery to I-II class.Conclusion:1Most of patients with IE were surfing from underlying cardiac diseases.some new predisposing factors such as intravenous drug use and cardiacinterventional therapy were also increased.2Clinical symptoms of IE were becoming atypical.The cardinalsymptom was fever accompany with anemia or thromboembolism sometimes.3Blood culture check and ultrasonic cardiogram was important fordiagnoses of IE.4The most common organism was Streptococcus viridiansStaphylococcus aureus.Some rare pathogenic bacteria were found in thisstudy.5The therapies of IE were medical treatment and surgical treatment.Patients with IE administer medical treatment only were often insufficient.Surgical treatment was needed for these patients.6Surgical treatment is different according to different patients.Thetreatments of IE need combination therapy of medical treatment and surgicaltreatment.Patients with primary heart disease or complications such asintractable heart failure and unmanageable infection should given surgicaltreatment to get a better treatment effect.7Patients continued to be treated with antibiotics for4～6weeks after surgery. Antifungal agents can be administered to avoid of fungal infection.8Handle of perioperative period is quite important to lower the risks ofsurgery.9The key of lower the rate of misdiagnose and increase the rate of cureis to enhance the understanding of IE.