By Henryk Siniawski
Active infective endocarditis is without doubt one of the so much critical ailments of the center. an infection usually motives periannular abscess, and should additionally unfold to impact the mitral valve constructions. This hardship incorporates a excessive mortality price and valve substitute by way of in depth care and antibiotic remedy could be the simply choice to shop patientsвЂ™ lives. critical hemodynamic melancholy brought on by bacterial surprise, is this day now not a counter-indication, and the second one significant hazard issue, that of postoperative reinfection, has been enormously diminished by utilizing homografts and new valve prostheses which are immune to bacterial an infection. well timed operation, sooner than complicated destruction of cardiac constructions happens, achieves a far better fee of survival.
This review of the result of surgery of lively infective endocarditis was once played on the German middle Institute Berlin. It specializes in preoperative research and proposes a brand new class of this endocarditic disease.
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Extra info for Active Infective Aortic Valve Endocarditis with Infection Extension: Clinical Features, Perioperative Echocardiographic Findings and Results of Surgical ... in der Herz-, Thorax- und GefГ¤Гџchirurgie)
Meta = tissue metastatic form of extension. Jet = jet lesion on mitral valve. VSD = endocarditic ventricular septum defect. 37 In summary, the main anatomic complications of aortic valve endocarditis (Table 22) were the following: there were 31 patients suffering from extension of endocarditis into the mitral valve area which was labeled as secondary damage of the mitral valve (MV metastatic and MV jet lesion). In three patients a fistula to the right atrium was recognized. Endocarditic VSD (ventricular septal defect) was found in two patients.
7 Table 14. 3%) patients suffering from vasoactive shock in whom sole aortic valve replacement was undertaken (Tables 13, 14). 7%) patients. In 13 patients a homograft was inserted in aortic position and only in 5 patients was a stentless aortic valve used. Mitral valve damage was observed in one case as local metastatic disease with destruction of the anterior mitral leaflet. In four cases a jet lesion of the anterior mitral leaflet with pseudoaneurysm formation was found. In all five cases mitral valve replacement (Shelhigh) was undertaken.
EDD postop. Phase I (no cavity) Phase II (closed cavity) Phase III (opened cavity) AV dehiscence Staph. aureus infection Streptoccoccus infection Table 25. Multivariate analysis of known preoperative and postoperative predictors as risk factors for deathPredictors The highest postoperative mortality rate (50%) occurred among patients suffering from fresh extended infection (no cavity) forming root abscess. 05 indicate strong influence of the early phase of abscess (infiltration) on the in-hospital mortality.