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Ann Thorac Surg 1998;66:1470-1471
© 1998 The Society of Thoracic Surgeons

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Correspondence

Reply

^a Department of Cardiac Surgery, University of Heidelberg, INF 110, 69120 Heidelberg, Germany

To the Editor

We appreciate the comments of Dr Moro and coworkers concerning our management of infective endocarditis, and we are pleased that they agree with our conclusions.

We are very well aware of the method of fringe reconstruction of the aortic root described by Hayashi and associates in 1996 [1], and we consider this procedure an interesting alternative to conventional root reconstruction even in cases of infective endocarditis.

Concerning the methods of reconstruction of abscess cavities after resection of infected tissue, we have not used glutaraldehyde-treated autologous pericardium for two reasons: (1) As has been stated for the valve prosthesis, we do not think that "resistance to infection" of any device or biological implant plays a crucial role in the outcome after operation for infective endocarditis. (2) In most cases, the valve prosthesis is to be sutured to the patch used for reconstruction; therefore, high mechanical stress to the patch has to be expected. The durability and freedom from structural deterioration of autologous pericardium used for these purposes have not yet been assessed.

For these reasons, we relied on Dacron or polytetrafluoroethylene patches for reconstruction. In fact, in a comparative study recently published by our group [2], we did not find differences in mortality, perioperative complications, freedom from recurrent endocarditis, and late complications among patients with and without aortic root abscesses. In these patients, reconstruction of abscess cavities was performed with Dacron patches whenever necessary.

References

1. Hayashi J., Eguchi S., Miyamura H., Moro H. Fringed valve prosthesis for aortic root abscess. Ann Thorac Surg 1996;62:262-264.[Abstract/Free Full Text]
2. Bauernschmitt R., DeSimone R., Lange R., Vahl C.F., Thomas G., Hagl S. Results of surgery for endocarditis of the aortic valve with paravalvular abscesses. German J Cardiol 1998;87:276-282.

This Article Full Text (PDF) 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 Author home page(s): Robert Bauernschmitt Siegfried Hagl Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bauernschmitt, R. Articles by Hagl, S. Search for Related Content PubMed PubMed Citation Articles by Bauernschmitt, R. Articles by Hagl, S.