ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Timing for surgical therapy in active infective endocarditis
Osman Tiryakioğlu1, Selma Kenar Tiryakioğlu 2, Tamer Türk 1, Hakan Özkan 2, Tahsin Bozat 2, Şenol Yavuz1
1Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Bursa
1Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Bursa
Background: Patients with active endocarditis undergoing urgent or first priority surgery for various reasons were compared.

Methods: Nineteen patients (14 males, 5 females mean age 30.8±12.3 years; range 19 to 54 years) with cardiac valvular involvement were retrospectively investigated. Five patients had aortic valve involvement, 8 patients had mitral valve and the remaining 6 had multivalve involvement. Surgery was performed to 13 (11 males, 2 females; mean age 31.6±10 years) out of 19 patients (68.4%) immediately in the early period (mean 5. day). We performed aortic valve replacement to 4 patients (1 patient had additional mitral valve repair), mitral valve replacement to 5 patients (2 patients had additional tricuspit valve repair), two valve replacement to 4 patients (1 patient had additional tricuspit valve repair). There were 6 patients (3 males, 3 females; mean age 29.3±15.5 years) who were not operated in the early term.

Results: Coagulase (+) Staphilococcus aureus was recovered from blood cultures in all patients undergoing surgery. In addition, Brucella agglutination test was found positive in one patient. One patient was reoperated in the early period due to paravalvular leakage. There was no operative mortality. Two patients who were not operated in the early period died during the first week of medical therapy. Three out of four patients who received medical therapy, were operated in the first year.

Conclusion: Although active infective endocarditis causes high risk for operation, operation decision must be taken as early as possible and results of medical therapy should not be waited.

Keywords : Endocarditis, bacterial/complications/surgery; heart valves/surgery
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