Surgical interference in cases of infective endocarditis [results and outcome]

ABSTRACT

Many patients with infective endocarditis [IE] present with serious and complicated courses that lead to significant morbidity and mortality. We followed up 39 cases of IE who were referred to surgery. Our patient population was comprised of 30 males and 9 females [aged between 7 and 52 years, mean 26.8 +/- 12.9 years]. Congenital heart disease was present in 7 of the patients while rheumatic heart disease was present in 32. The patients presented with congestive heart failure [CHF] in 26, and systemic embolization in 5. Blood cultures were positive in 30 [76.9%] of the patients, while vegetations were detected by 2-dimensional echocardiography in 28 patients [71.7%]. Elective surgery was performed in 36 patients and emergency operation for systemic arterial embolizalion and/or intractable CHF in 3 patients. Four patients required re-operation for post-operative bleeding. All patients were followed up for 6 months with no evidence of re-infection. Four patients died, 2 due to intracranial bleeding from the use of anticoagulation for the mechanical valve implanted, and 2 died due to septicaemia. The remaining patients resumed normal activity. The encouraging outcome of our study suggests that surgical intervention for IE, is a relatively safe procedure for patients with complicated IE, early diagnosis and early intervention are expected to improve the morbidity and mortality of patients with IE