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J Thorac Cardiovasc Surg 2007;133:149
© 2007 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Discussion

Dr Steven W. Guyton (Seattle, Wash). Thank you, Dr Gavra, for an excellent presentation and for the opportunity to review your manuscript before the meeting.

Active endocarditis that cannot be managed with antibiotic therapy alone is a devastating problem, as you have so well illustrated. You might illustrate this as well by including a graph indicating the freedom from mortality and morbidity—reoperation, recurrent endocarditis, thromboembolism, stroke, heart block, renal failure, sternal infection, and others. I anticipate that close to 100% of your patients will show complications during your 10- to 15-year follow-up. I agree with your emphasis on aggressive débridement of all infected tissue and less emphasis on the type of prosthesis. The prostheses you used were approximately 2:1 mechanical versus bioprosthetic and then some homografts. Have you seen a difference in outcomes depending on . . . [Full Text of this Article]

Related Article

Surgical treatment of active infective endocarditis: A continued challenge

Tirone E. David, Gheorghe Gavra, Christopher M. Feindel, Tommaso Regesta, Susan Armstrong, and Manjula D. Maganti
J. Thorac. Cardiovasc. Surg. 2007 133: 144-149. [Abstract] [Full Text] [PDF]