Revista medica de Chile · 2004
[Valve repair surgery in infectious endocarditis].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Zalaquett Ricardo, Garrido Luis, Casas Francisca, Morán Sergio, Irarrázaval Manuel J, Becker Pedro, Braun Sandra, Córdova Samuel, Chamorro Gastón, Godoy Iván, Yáñez Fernando, Labarca Jaime, Pérez Carlos
Аннотация
BACKGROUND: Valve replacement has been the treatment of choice for patients with valvular complications of infectious endocarditis (IE). However, excellent results with valve repair allowed it to become a new therapeutic alternative for these patients.
AIM: To evaluate the results of valve repair in patients with valvular complications of IE.
PATIENTS AND METHODS: From January 1991 to December 2000, 14 patients with valvular complications of IE underwent valve repair. Mean age was 37.9 +/- 14.9.
RESULTS: New York Heart Association (NYHA) class was 2.8 +/- 0.9. IE was located in the aortic in 6 (42%), in the mitral valve in 4 (29%) and in both valves in 4 cases (29%). Surgical indication was hemodynamic in 50% of the cases, echocardiographic in 29% and septic in 21%. Five aortic valves were bicuspid, 3 mitral valves were myxomatous and the rest were normal. The most common septic lesions were vegetations and leaflet perforations. A total of 23 aortic and 21 mitral valve repair procedures were performed. There were no deaths. Only 1 patient had a surgical complication (renal failure and prolonged mechanical ventilation). Follow-up was 100% complete. There was not late mortality. One patient with bone marrow aplasia required reoperation for a new episode of IE 19 months later. At the end of the follow-up NYHA class was 1.3 +/- 0.6 and echocardiography showed a mild or absence of valve regurgitation in most patients.
CONCLUSIONS: Valve repair surgery in IE has good results, with advantages over valve replacement.
AIM: To evaluate the results of valve repair in patients with valvular complications of IE.
PATIENTS AND METHODS: From January 1991 to December 2000, 14 patients with valvular complications of IE underwent valve repair. Mean age was 37.9 +/- 14.9.
RESULTS: New York Heart Association (NYHA) class was 2.8 +/- 0.9. IE was located in the aortic in 6 (42%), in the mitral valve in 4 (29%) and in both valves in 4 cases (29%). Surgical indication was hemodynamic in 50% of the cases, echocardiographic in 29% and septic in 21%. Five aortic valves were bicuspid, 3 mitral valves were myxomatous and the rest were normal. The most common septic lesions were vegetations and leaflet perforations. A total of 23 aortic and 21 mitral valve repair procedures were performed. There were no deaths. Only 1 patient had a surgical complication (renal failure and prolonged mechanical ventilation). Follow-up was 100% complete. There was not late mortality. One patient with bone marrow aplasia required reoperation for a new episode of IE 19 months later. At the end of the follow-up NYHA class was 1.3 +/- 0.6 and echocardiography showed a mild or absence of valve regurgitation in most patients.
CONCLUSIONS: Valve repair surgery in IE has good results, with advantages over valve replacement.