1.Surgical treatment of aortic periannular abscess in 162 patients
Lanxin YE ; Fanyu CHEN ; Oudi CHEN ; Lixi GAN ; Hongkun QING ; Weiteng WANG ; Xuhua JIAN
Chinese Journal of Thoracic and Cardiovascular Surgery 2024;40(9):536-541
Objective:To report the surgical experience and long-term survival in patients with infective endocarditis associated with aortic periannular abscess.Methods:We retrospectively analyzed collected data on all 162 patients who underwent surgical treatment between December 2010 and May 2023 in our hospital.Results:128 were male(79.0%). Patients' mean age was(47.9±15.1) years. The infected valve was prosthetic in 11 patients(6.8%). All patients underwent aortic valve replacement(100%) and 22 patients(13.5%) received aortic root replacement. Operative mortality was 6.8% (n=11)(prosthetic valve endocarditis vs native valve endocarditis, 18.2% vs. 6.0%, P=0.17). Postoperative mean follow-up was (34.00±2.19) months. 1 patient(1.2%) died during follow-up. Endocarditis recurred in 3 patients(1.8%) at a mean of (2.1±0.6) years. Survival at 3 years and 5 years were 90.0% and 86.9%, respectively. Conclusion:Infective endocarditis with a secondary aortic root abscess can lead to necrosis of the valve's surrounding tissues. Positive surgical intervention can improve the patient's prognosis and survival.
2.Application of Commando and Hemi-Commando procedures in the reconstruction of intervalvular fibrous body
Weiteng WANG ; Hongkun QING ; Oudi CHEN ; Lixi GAN ; Fanyu CHEN ; Xin LI ; Xuhua JIAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(07):991-999
Objective To analyze the short- and mid-term outcomes of patients undergoing reconstruction of intervalvular fibrous body (IVFB) via double valve replacement (Commando procedure) or aortic valve replacement and mitral valve repair (Hemi-Commando procedure). Methods The patients who underwent Commando or Hemi-Commando procedure between September 2014 and September 2022 in Guangdong Provincial People’s Hospital were collected. The perioperative and follow-up data were reviewed and analyzed for the assessment of short- and mid-term outcomes. Results Eleven patients received Commando procedure (a Commando group), including 4 males and 7 females with a median age of 61 (33, 68) years; 7 patients received Hemi-Commando procedure (a Hemi-Commando group), including 5 males and 2 females with a median age of 50 (36, 58) years. Two patients died in the postoperative 30 days (1 patient in the Commando group and 2 patients in the Hemi-commando group). Low cardiac output syndrome complicated with multiple organ dysfunction syndrome was the main cause of death. Fifteen patients were discharged and followed up for 13 (6, 42) months, with a survival rate of 100%. The rates of free from recurrent endocarditis or re-operation were both 100%. Conclusion Commando and Hemi-Commando procedures are effective strategies for IVFB reconstruction, and can achieve excellent mid-term outcomes if patients survive from the frailest period of early postoperative stage.