Prosthetic valve endocarditis indications of surgical treatment from analysis of 11 cases
Aoyagi, S.; Kosuga, K.; Hara, H.; Yanagi, I.; Shima, H.; Oishi, K.
Nihon Kyobu Geka Gakkai 35(8): 1216-1221
1987
ISSN/ISBN: 0369-4739 PMID: 3668348 Document Number: 294010
During the period from 1975 to December 1985, eleven patients developed prosthetic valve endocarditis (PVE). Infection occurred in 5 patients within 60 days after surgery and in 6 thereafter respectively. As organism, Staphylococcus species and Gram-negative bacilli were noted in 3 of 2 of the patients with early onset. Streptococcus species and Staphylococcus species were found in 3 of 2 of those with late onset. Four of seven patients with infection due to Staphylococcus species and Gram-negative bacilli died of CHF, cerebral hemorrhage and sudden cardiac arrest, but only of 3 patients with infection due to Staphylococcus species died of new infection after replacement of infected prosthetic valve. Four of 6 patients who had antimicrobial therapy alone died. Remaining 2 who had no abnormal echocardiographic findings and no prosthetic dysfunction were noted, survived. Five patients survived by antimicrobial therapy and replacement of infected valves. Mortality rate of patients in early and late onset were 60% and 33.3% respectively. Over-all mortality was 45.5%. Early replacement of infected prosthetic valves should be considered in all patients except those with late onset infection caused by Streptococcus species.