Pranas Šerpytis


Summary: Data about patients diagnosed with IE, surgically treated in Vilnius University Hospital Santariškių clinics during the period of 2007 – 2009 years is analised in this article. A diagnosis of IE was based on Duke criterias in all the cases [1].
Epidemiological, etiological, clinical, microbiological, laboratory data are discussed in the article.In hospital mortality rate and it`s determining factors were analised. A relation between patients age and all the data was analised.
During the research all the patients were devided into three age groups: group A was formed with patients between 22 and 39 years old, group B – between 40 and 59, group C included patients over 60 years old.
101 adults (73 men, 28 women, middle age 55,82 ± 14,87) entered the research. 90,1% (91) were diagnosed with native valve endocarditis. In group A  tricuspid valve was usually damaged (40,0% (8)), in group B – aortic valve (56,3% (18)), in group C – mitral valve (38,8% (19)), p<0,01.
Predisposing factors, such as diabetes mellitus, rheumatic heart disease, insufficiency of renal function, cancer, injury were more common among the patients of group C (67,3% (33), p=0,017).
Intracardiac complications such as valvular abscess, perivalvular abscess, valvular fistula, cuspid aneurism of the valve occurred in 29,7% (30) of all cases to compare with 90,0% (9) in prosthetic IE cases, p<0,01.
Heart failure, NYHA IV functional class evaluated as a mortality increasing factor (p<0,01).
Staphylococcus aureus was the most common causative microorganism grown out of a blood culture in 35,7% (15) cases versus Enterococcus faecalis mostly (35,7% (5)) grown out of valve tissue samples. IE caused by stafilococcal microorganisms was treated with Vancomicin in 73,1% (19) of cases (p=0,005).
A heart valve prosthesis implantation was performed in 97,0% (98) of cases. A biological prosthesis was usually implanted in group A – 45,0% (9) of cases, p=0,010.
Bleeding was the most common (18,8% (19)) among all the postoperative complications which occurred in 52,5% (53) of cases. In hospital mortality rate determined to be 14,9% (15), in line with 5% (1);  3,1% (1);  26,5% (13) in groups A; B; C.

Keyword(s): infective endocarditis, heart valve prosthesis implantation, heart failure, mortality.
DOI: 10.5200/144
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