ABSTRACT
Thirty five patients were included in this study [20 males and 15 females]. Their ages ranged from 14 to 40 years [mean age was 24 years]. All of them had subjected to cardiac surgery at the cardiothoracic surgery department of Ain-Shams University Hospitals. All the patients, had rheumatic heart lesions. C-reactive protein [CRP] levels were measured preoperatively, and postoperatively in the 1st, 3rd, 5th, 7th, 9th, 15th and 30th postoperative day. The normal curve of CRP levels as a body response to the surgical cardiac trauma in uncomplicated cases was drawn from a control group. It was found that CRP levels showed a rapid increase following cardiac surgery reaching a peak after 24 - 48 hours postoperatively, followed by slow gradual decline to reach the preoperative level by the end of the first month. Any deviation from this curve may denote hidden infection, PVE [prosthetic valve endocarditis] or mediastinitis. The pattern of CRP in cases complicated by infections showed either persistent or secondary rise according to the time of occurrence of infection. Serial measurements of CRP for each patient was found to be of greater help in early detection of infection and in monitoring the response to therapy than single estimation. Blood culture is a must in cases suspected of having septicaemia and / or endocarditis. If positive, it is of great help in nigdifinhie effective antibiotics and appropriate therapy. The value of serum CRP level is good especially when correlated with the clinical picture of the patients