Pranas Šerpytis, Palmyra Semėnienė, Rasa Čypienė, Arimantas Grebelis, Jonas Misiūra, Irina Alitoit, Akvilė Šmigelskaitė
This article describes the tendencies of surgical treatment of the patients, admitted to Vilnius University Hospital Santariškių Klinikos due to infectious endocarditis, during the period of 2007-2009 years. Objective. To assess the factors influencing the timing of surgery. To determine if timing of surgery impacts an outcome of infective endocarditis. Design and methods: Demographic, clinical, transthoracic/ transesophagal echocardiographic, microbiological, operation protocol data were analyzed. During the research patients were defined into two different groups by timing of surgical treatment. Surgery performed during the first 7 days after an admission to hospital was named as an emergent/ urgent (n=50), later surgery – as an elective (n=50). Finally, 100 patients with Duke Criteria based diagnosis entered the research. Results. There was a relation between the timing of surgery and etiologic factors of infective endocarditis evaluated, p = 0,034. Patients with diagnosis of prosthetic infective endocarditis received an elective surgical treatment usually – 9 (90%), p = 0,008. Refracteric lung edema required an urgent surgical treatment – 9 (82%), p = 0,050. If intracardiac complications were present, surgical treatment was usually delayed – 20 (70%) cases, p=0,008. The length of vegetations (more than 15 mm) did not influence on timing of surgery. The timing of surgical treatment due to infective endocarditis had no influence on the mortality rates, which were the same – 14% – in both groups.
Keyword(s): infective endocarditis; heart failure; heart valve prosthesis implantation
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