[Surgery for bacterial endocarditis: retrospective study of 32 patients].

BACKGROUND

Surgery for active endocarditis is indicated in cases of congestive heart failure (CHF), persistent sepsis, systemic embolization and paravalvular involvement.

AIM: To assess and report the long term results of surgery in adult patients.

PATIENTS AND

METHODS

Retrospective review of clinical records and operative procedures of 32 patients aged 43+/- 13 years (28 women) subjected to reparative surgery for complications of endocarditis between 1993 to 2005.

RESULTS

In 25% of cases, endocarditis presented as a prolonged sepsis syndrome and in 31% as a CHF or both. The causative bacteria was Gram (+) in 53% and blood cultures were negative in 47%. Preoperative echocardiography showed vegetations in 56% of cases. An annular abscess, aortic valve rupture and bicuspid valve, was observed in 13% of patients. Post operative mortality was due to persistent sepsis and multi-organic dysfunction in 16%. Mean long term follow up was 43.8+/-47.2 months. Actuarial survival was 78% at 146 months.

CONCLUSION

Surgical management of active endocarditis provides a good symptomatic recovery, with an excellent long term actuarial survival.