Journals / MN Kardiyoloji / 2000 / Cilt: 7 - Sayı: 2
The results of surgical treatment in the active and chronic infective endocarditis
- Journal
- MN Kardiyoloji
- Pages
- 137–142
- DOI
- —
Abstract
AIM: The early and long-term results of surgical treatment and active and chronic infective endocarditis were investigated retrospectively. MATERIAL AND METHODS: During the period between 1969 and 1999, 110 patients were operated with the diagnosis of infective endocarditis. 32 patients (29%) were women and 78 (71%) were men and the average age was 35±12 years. Of these 110 cases, 80 (73%) were nativ valve endocarditis, 24 (22%) were prosthetic valve endocarditis and 6 (5 %) were endocarditis related to congenital cardiac anomalies. Most frequent clinical findings were, fever resistant to treatment, fatique and malaise and congestive heart failure. Streptococus viridans was the most frequently isolated causative microorganism (27%). RESULTS: 98 patients (89%) received mechanical valves and 3 patients (2,7%) had bioprosthetic valves. Reconstruction was made in 9 cases (8%). 5 (4,5%) patients were lost during early postoperative period. 79 % of the cases were followed for the 2 to 272 months. 2 patients were lost during the late follow-up. 4 reoperations were done to 3 patients. CONCLUSION: Successful results may be achieved with early surgical intervention for the cases with high probability of failure to medical therapy or the cases unresponsive to medical therapy during the course of infective endocarditis.
Özet
AMAÇ: Aktif ve iyileşmiş endokarditli hastalarda cerrahi tedavinin erken ve geç dönem sonuçları rektospektif olarak incelendi. GEREÇ VE YÖNTEM: Türkiye Yüksek İhtisas Hastanesi, Kardiyovasküler Cerrahi Kliniği'nde, 1969-1999yılları arasında 110 olgu İnfektif endokardit tanısı ile ameliyat edilmiştir. Olguların 32 'si (% 29) kadın, 78 'i (% 71) erkek ve ortalama yaş 35±12 yıl idi. Olguların 80 7 (% 73) nativ kapak, 24 'ü (% 22) protez kapak, 6'sı (% 15) konjenital anomalilere bağlı endokardit idi. En sık görülen klinik bulgu tedaviye dirençli ateş, halsizlik ve konjestif kalp yetmezliği idi. En sık etken olarak streptococcus viridans (% 27) tespit edildi. BULGULAR: Olguların 98'ine (% 89) mekanik kapak, 3'üne (% 2.7) bioprotez kapak ile replasman yapıldı. 9 (% 8) olguda rekonstrüktif işlem yapıldı. Olguların 5'i (% 4.5) erken dönemde kaybedildi. Olguların % 79'u takip edildi (2 ay - 272 ay). Uzun dönemde 2 olgu (% 1.8) kaybedildi. 3 olguya 4 reoperasyon uygulandı. SONUÇ: Medikal tedavinin yetersiz kaldığı veya yüksek başarısızlık ihtimalinin olduğu olgularda yapılan erken cerrahi müdahale ile başarılı sonuçlar elde edilebilmektedir.