HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mammana, R. B. Articles by Silverman, N. A. Search for Related Content PubMed PubMed Citation Articles by Mammana, R. B. Articles by Silverman, N. A.

The Annals of Thoracic Surgery, Vol 35, 436-441, Copyright © 1983 by The Society of Thoracic Surgeons

ARTICLES

Valve replacement for left-sided endocarditis in drug addicts

RB Mammana, S Levitsky, D Sernaque, CB Beckman and NA Silverman

Eighteen drug addicts with left-sided valvular endocarditis requiring operation are reviewed. Gram-positive bacteria were the most common organisms cultured (61%), with Staphylococcus aureus present in 7 of 11 patients. Gram-negative bacteria, exclusively Pseudomonas aeruginosa, were cultured in the remaining 39%. Indications for operation included sepsis (61%), heart failure (78%), and systemic emboli (22%). Abscesses formed in 6 of 11 patients with gram-positive endocarditis, while only one abscess was present with gram-negative endocarditis. Normal valves were infected in 17 of 18 patients (94%). Early surgical mortality (less than 30 days) was 11%. There were major complications in 79% of these patients, including persistent sepsis (50%), valvular dehiscence, prosthetic endocarditis or perivalvular leakage (37%), and mycotic aneurysms (22%). These complications were directly related to a late mortality of 44%, yielding an overall mortality of 50% in the first nine months after operation. Contrary to previous reports of acceptable surgical survival for valvular endocarditis, these data suggest that endocarditis involving the aortic or mitral valve in a drug addict is a highly lethal disease due to the virulence of the organisms, the severity of the complications encountered, and the predisposition to continued addiction.

This article has been cited by other articles:

				A. Wahba and D. Nordhaug What are the long-term results of cardiac valve replacements in left sided endocarditis with a history of i.v. drug abuse? Interactive CardioVascular and Thoracic Surgery, October 1, 2006; 5(5): 608 - 610. [Abstract] [Full Text] [PDF]

				L. M. Baddour, W. R. Wilson, A. S. Bayer, V. G. Fowler Jr, A. F. Bolger, M. E. Levison, P. Ferrieri, M. A. Gerber, L. Y. Tani, M. H. Gewitz, et al. Infective Endocarditis: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: Endorsed by the Infectious Diseases Society of America Circulation, June 14, 2005; 111(23): e394 - e434. [Abstract] [Full Text] [PDF]

				F. J. Baumgartner, B. O. Omari, J. M. Robertson, R. J. Nelson, A. Pandya, A. Pandya, and J. C. Milliken Annular abscesses in surgical endocarditis: anatomic, clinical, and operative features Ann. Thorac. Surg., August 1, 2000; 70(2): 442 - 447. [Abstract] [Full Text] [PDF]