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 al Jubair, K. Articles by Sawyer, W. Search for Related Content PubMed PubMed Citation Articles by al Jubair, K. Articles by Sawyer, W.

The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 487-490, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Cardiac operations during active endocarditis

K al Jubair, MR al Fagih, A Ashmeg, M Belhaj and W Sawyer
Riyadh Cardiac Centre, Armed Forces Hospital, Saudi Arabia.

Between December 1982 and March 1990, 65 patients with active infective endocarditis underwent cardiac operations. Their mean age was 28.6 years (range 1 to 65 years). The most common infecting organisms were staphylococcus (33.8%), streptococcus (18.5%), and brucella (16.9%); 11 patients (16.9%) had cultures negative for infection. A rheumatic, native valve, most commonly the aortic, was involved in 40 patients, a prosthetic valve (with the mitral most common) in 18 patients, and in seven patients the infection involved a congenitally abnormal valve. Aortic root abscess developed in 21.5% of patients. In 30 patients operation was performed within 3 days of the start of intravenous antibiotic therapy, usually within 3 days of admission (group A); this resulted in fewer preoperative complications and a significantly lower postoperative complication rate than in those 35 patients who underwent operations more than 3 days after starting antibiotic therapy (group B). Preoperative embolic phenomena occurred in eight (12.3%) of the 31 patients who had large, mobile vegetations (2/16 [12.5%] in group A and 6/15 [40%] in group B). Overall there was no reinfection. No postoperative paravalvular leaks developed in group A. Nine patients died in the hospital (13.8%) (four in group A and five in group B); in all patients the infecting organism was staphylococcal or fungal. There was one late death. Early operation should always be considered in active infective endocarditis, especially when a prosthetic valve is involved or the infecting organism is staphylococcal or fungal. The disclosure of moderate to large vegetations by two-dimensional echocardiography is an indication for operation.

This article has been cited by other articles:

				E. M. Delmo Walter, M. Musci, N. Nagdyman, M. Hubler, F. Berger, and R. Hetzer Mitral Valve Repair for Infective Endocarditis in Children Ann. Thorac. Surg., December 1, 2007; 84(6): 2059 - 2065. [Abstract] [Full Text] [PDF]

				A. Renzulli, R. Gregorio, G. Romano, A. Carozza, J. Marmo, R. Utili, M. De Feo, and M. Cotrufo Brucella Endocarditis: Seven Cases Treated Surgically Asian Cardiovasc Thorac Ann, December 1, 1999; 7(4): 272 - 275. [Abstract] [Full Text] [PDF]

				B. A. Carabello and F. A. Crawford Valvular Heart Disease N. Engl. J. Med., July 3, 1997; 337(1): 32 - 41. [Full Text] [PDF]

				F. Jault, I. Gandjbakhch, A. Rama, M. Nectoux, V. Bors, E. Vaissier, P. Nataf, A. Pavie, and C. Cabrol Active Native Valve Endocarditis: Determinants of Operative Death and Late Mortality Ann. Thorac. Surg., June 1, 1997; 63(6): 1737 - 1741. [Abstract] [Full Text]