Surgical Management of Infective Endocarditis Complicated by Embolic Stroke: Early versus Delayed Surgery
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 332-337, 2011.
Artigo
em Inglês
| WPRIM
| ID: wpr-151528
ABSTRACT
BACKGROUND:
The optimal timing of surgery for infective endocarditis complicated by embolic stroke is unclear. We compared early versus delayed surgery in these patients. MATERIALS ANDMETHODS:
Between 1992 and 2007, 56 consecutive patients underwent open cardiac surgery for the treatment of infective endocarditis complicated by acute septic embolic stroke, 34 within 2 weeks (early group) and 22 more than 2 weeks (delayed group) after the onset of stroke.RESULTS:
The mean age at time of surgery was 45.7+/-14.8 years. Stroke was ischemic in 42 patients and hemorrhagic in 14. Patients in the early group were more likely to have highly mobile, large (>1 cm in diameter) vegetation and less likely to have hemorrhagic infarction than those in the delayed group. There were two (3.7%) intraoperative deaths, both in the early group and attributed to neurologic aggravation. Among the 54 survivors, 4 (7.1%), that is, 2 in each group, showed neurologic aggravation. During a median follow-up of 61.7 months (range, 0.4~170.4 months), there were 5 late deaths. Overall 5-year neurologic aggravation-free survival rates were 79.1+/-7.0% in the early group and 90.9+/-6.1% in the delayed group (p=0.113).CONCLUSION:
Outcomes of early operation for infective endocarditis in stroke patients were similar to those of the conventional approach. Early surgical intervention may be preferable for patients at high risk of life-threatening septic embolism.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Cirurgia Torácica
/
Taxa de Sobrevida
/
Seguimentos
/
Sobreviventes
/
Acidente Vascular Cerebral
/
Embolia
/
Endocardite
/
Infarto
/
Manifestações Neurológicas
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
Idioma:
Inglês
Revista:
The Korean Journal of Thoracic and Cardiovascular Surgery
Ano de publicação:
2011
Tipo de documento:
Artigo
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