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Ann Thorac Surg 1986;42:148-151
© 1986 The Society of Thoracic Surgeons

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Articles

Successful Management of Aortic Valve Endocarditis with Associated Periannular Abscess and Aneurysm

Department of Surgery, Section of Cardiothoracic Surgery, University of Oklahoma College of Medicine, Oklahoma City, OK

^* Address reprint requests to Dr. Elkins, Section of Cardiothoracic Surgery, University of Oklahoma College of Medicine, PO Box 26307, Oklahoma City, OK 73126

Aortic valve endocarditis extending beyond the aortic root presents a particularly difficult management problem. During a four-year period we have seen four patients with extensive annular abscesses involving the native valve (in 1 patient) and prosthetic valves (in 3). In all these patients the aortic roots were debrided and valved conduits were replaced with coronary artery grafts while appropriate antibiotics were administered. Postoperative complications included conduction abnormalities, hemorrhage, and low cardiac output, but all 4 patients were discharged from the hospital. Two patients died, 1 of an unrelated disease at 13 months postoperatively and 1 of endocarditis at 16 months postoperatively. The two remaining patients are alive and well at 11 and 46 months postoperatively. We conclude that, in spite of the prosthetic material required, this procedure permits adequate debridement and safe reconstruction for the rare patient in whom endocarditis has resulted in aortic-ventricular discontinuity.

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