[Prevention of prosthetic heart valve infection]. / Profilaktika infitsirovaniia iskusstvennykh klapanov, implantirovannykh v serdtse.

Fourty patients with primary and secondary infective endocarditis of the native heart valves as well as patients with rheumatic heart diseases not complicated by infective endocarditis were operated upon in the clinic from 1996 till 1998. The prosthetic heart valves in which the tissue cuff was sutures by blanket suture along the perimeter with a silver thread were implanted to 25 patients. In the other 15 patients (a control group) prosthetics were made using unchanged construction of the prosthesis (without the silver thread). Patients with valve prostheses sutured with the silver thread had smooth postoperative period. They had no prosthetic endocarditis either at the early or at late postoperative periods. In 3 patients of the control group infective endocarditis of the valve prosthesis developed at different periods after operation. All of them were reoperated. The authors consider that defense of the tissue cuff of the prosthetic valve with the silver thread allows risk of the development of prosthetic endocarditis to be substantially reduced. In the cases described it was completely avoided.

[The current potentials and the role of echocardiography in the diagnosis and surgical treatment of infectious endocarditis]. / Sovremennye vozmozhnosti i rol' ékhokardiografii v diagnostike i khirurgicheskom lechenii infektsionnogo éndokardita.

The authors have analyzed results of examination of 107 patients with infective endocarditis (IE) of the natural (IENV) and artificial valves (IEAV) of the heart. It was found that the revealed ultrasonic symptoms of IE were specific in 97.7% of patients with IENV and in 100% of patients with IEAV. The sensitivity of transthoracal echocardiography was 89.6% in patients with IENV and 65% in patients with IEAV. The intracardiac morphological alterations were found to coincide with the findings of echocardiography in 78.2% of patients with IENV and in 55%--with IEAV. The authors have elaborated an algorithm of the complex diagnostic examination of patients.

[Radionuclide study in the diagnosis of infectious foci in heart surgery patients]. / Radionuklidnoe issledovanie v diagnostike ochagov infektsii u kardiokhirurgicheskikh bol'nykh.

The radionuclide investigation was performed 1-3 and 24 hours after injection of a radiopharm preparation and included the single photon emission computed tomography of the heart and scintigraphy of the whole body. Inflammation foci were found on the scans as hyperfixation foci of autoleukocytes labeled with 99mTc-HMPAO (hexamethylpropilene aminooxime). Four patients had abscesses with 0.8-1.5 cm diameter in projection of the aortal and mitral valves of the heart, and in 10 patients there were foci of inflammation and suppuration of extracardiac localization (in the area of the operation wound, anterior mediastinum, frontal sinuses, transverse colon, parietal pleura). The data obtained convincingly speak of high sensitivity and specificity of radionuclide diagnostic methods with the help of labeled elements of the whole blood in recognizing latent inflammatory and suppurative processes in cardiosurgical patients at the pre- and postoperative periods.