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The Annals of Thoracic Surgery, Vol 49, 701-705, Copyright © 1990 by The Society of Thoracic Surgeons
TE David, J Bos, GT Christakis, PR Brofman, D Wong and CM Feindel
Sixty-two consecutive patients underwent heart valve operation for active
infective endocarditis. There were 42 men and 20 women whose mean age was
49 years (range, 21 to 79 years). The infection was in the aortic valve in
37 patients, the mitral valve in 18, the aortic and mitral valves in 5, and
the tricuspid valve in 2. Twenty-four patients had prosthetic valve
endocarditis. Staphylococcus and Streptococcus were responsible for 86% of
the infections. Annular abscess was encountered in 33 patients. Complex
valve procedures involving reconstruction of the left ventricular inflow or
outflow tract or both were performed in 31 patients. There were three
operative deaths (4.8%). Predictors of operative mortality were prosthetic
valve endocarditis, preoperative shock, and annular abscess. Patients were
followed for 1 month to 130 months (mean follow-up, 43 months). Only 1
patient required reoperation for persistent infection. There were ten late
deaths. Most survivors (96%) are currently in New York Heart Association
class I or II. The 5-year actuarial survival was 79% +/- 7%. These data
demonstrate excellent results in patients with native valve endocarditis,
and support the premise that patients with prosthetic valve endocarditis
should have early surgical intervention.
ARTICLES
Heart valve operations in patients with active infective endocarditis
Division of Cardiovascular Surgery, Toronto Western Hospital, Ontario, Canada.
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