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Asian Cardiovasc Thorac Ann 2002;10:298-301
© 2002 Asia Publishing EXchange Pte Ltd

ORIGINAL CONTRIBUTION

Early Surgical Intervention for Infective Endocarditis

Zhu Hong Sheng, MD, Yao Pei Yan, MD, Zheng Jia Hao, MD, A Thomas Pezzella, MD1

Ren Ji Hospital Shanghai Second Medical University Shanghai, People's Republic of China
1 Division of Cardiothoracic Surgery Department of Surgery University of Massachusetts Medical Center Worcester, Massachusetts, USA
For reprint information contact: A Thomas Pezzella, MD Tel: 1 605 399 4810 Fax: 1 618 241 3831 email: Thomas_Pezzella_MD{at}ssmhc.com Department of Cardiothoracic Surgery, Good Samaritan Hospital, 605 North 12th Street, Mount Vernon, IL 62864, USA.
Infective endocarditis remains a serious and complex disease with significant morbidity and mortality. Sixty cases of infective endocarditis were retrospectively reviewed, consisting of 41 males and 19 females aged 7 to 50 years (mean, 30 years). Congenital heart disease was diagnosed in 19 of the patients and rheumatic heart disease in 41. Congestive heart failure occurred in 36 and systemic embolism in 8 cases. Blood cultures were positive in only 21.7% of the cases, while vegetations were detected by 2-dimensional echocardiography in 70%. Elective surgery was performed in 57 patients and emergent operation for systemic arterial embolization and/or intractable congestive heart failure in 3 patients. Two patients required reoperation for postoperative bleeding. All but 2 patients had been followed up for 6 to 160 months with no evidence of reinfection. Three patients with mechanical valve implantation later died of intracranial bleeding due to over-anticoagulation. The remaining 55 resumed normal activity. The encouraging outcomes were the result of an aggressive diagnostic approach and early surgical intervention.






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