Mid-term results of surgical treatment for prosthetic valve endocarditis
10.7507/1007-4848.201704022
- VernacularTitle:人工瓣膜心内膜炎的外科治疗及中期随访结果
- Author:
BAO Chunrong
1
;
MEI Ju
1
;
DING Fangbao
1
;
ZHANG Yunjiao
1
;
ZHANG Li
1
;
TANG Min
1
;
ZHU Jiaquan
1
;
MA Nan
1
;
ZHANG Junwen
1
Author Information
1. Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200092, P.R.China
- Publication Type:Journal Article
- Keywords:
Heart valve prostheses implantation;
prosthetic valve endocarditis;
cardiac surgery procedure
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2017;24(9):687-691
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the mid-term results of surgical treatment for prosthetic valve endocarditis (PVE). Methods We retrospectively analyzed the clinical data of 22 PVE patients operated in our institution from January 2006 to June 2016. There were 14 males and 8 females, aged 31-62 (49.6±11.8) years. PVE occurred following single valve replacements in 20 patients, including aortic valve replacements in 12 and mitral valve replacements in 8. Two patients suffered PVE after multi-valve replacement, which was aortic and mitral valves. Mechanical valves were used in all patients. Early PVE (<1 year after valve implantation) was detected in 10 patients, and late PVE (>1 year after valve implantation) in 12 patients. Blood culture was negative in 6 patients. Fifteen patients underwent emergent or urgent surgery (within one week after definite diagnosis) and 7 elective surgery. Paravalvular abscess was detected in 12 patients and repaired bovine pericardium. Results Three patients (13.6%) died postoperatively in hospital, among whom two died of multiple systemic organ failure, and the other died of cerebral hemorrhage. Main postoperative complications included low cardiac output syndrome in 5 patients (22.7%), renal dysfunction in 6 (27.3%), respiratory failure in 5 (22.7%) and pulmonary infection in 4 (18.2%). During the follow-up of 6-120 (53.6±20.8) months, 2 deaths were observed in the middle term, including one sudden death and the other of cerebral infarction. No recurrent infection or valve-related surgery was observed during the follow-up. The survival rate was 86.4% in 1 year and 70.4% in 5 years. Conclusion PVE is a very severe disease with high mortality. Early surgical treatment and complete removal of infectious tissues have preferable early- and mid-term results.
