The incidence of infective endocarditis is 1.5-4.95 cases per 100,000 individuals per year, with a mortality of 14-46% 1-year post infection. The management and decision to operate on selected patients remains controversial. Our study reviews cases of native and prosthetic valve endocarditis in a surgical population, in an attempt to identify and compare clinical and microbiologic features between the two groups. In addition, we compared our findings with other published series to identify if there are changes with these parameters over time.

Aortic valve sparing operations were developed to preserve the native aortic valve during surgery for aortic root aneurysm as well as surgery for ascending aortic aneurysms with associated aortic insufficiency. There are basically two types of aortic valve sparing oprations: remodeling of the aortic root and reimplantation of the aortic valve. These operations have been performed for over two decades and the clinical outcomes have been excellent in experienced hands. Although remodeling of the aortic root is physiologically superior to reimplantation of the aortic valve, long-term follow-up suggests that the latter is associated with lower risk of developing aortic insufficiency. Failure of remodeling of the aortic root is often due to dilatation of the aortic annulus. Thus, this type of aortic valve sparing should be reserved for older patients with ascending aortic aneurysm and normal aortic annulus whereas reimplantation of the aortic valve is more appropriate for young patients with inherited disorders that cause aortic root aneurysms. This article summarizes the published experience with these two operations. They are no longer experimental procedures and should be part of the surgical armamentarium to treat patients with aortic root aneurysm and ascending aortic aneurysms with associated aortic insufficiency.
Aneurysm ; Aortic Aneurysm ; Aortic Valve ; Dilatation ; Hand ; Humans ; Replantation