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首页> 外文期刊>Journal of cardiac surgery. >Surgical treatment of acute infective valvular endocarditis (18 years experience).
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Surgical treatment of acute infective valvular endocarditis (18 years experience).

机译：急性感染性瓣膜性心内膜炎的外科治疗（18年经验）。

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摘要

BACKGROUND: Infective endocarditis morbidity remains high: 3 to 8 cases per 100,000 of population. Antibiotic therapy is ineffective. Its surgical treatment experience is relatively limited. Aim: To share the surgical treatment experience of 855 patients with acute infective valvular endocarditis (AIVE) treated during 1982 to 2000 in the Institute of Cardiovascular Surgery AMS, Ukraine. MATERIALS AND METHODS: 855 (75.4%) of 1128 hospitalized patients with AIVE were operated upon. Surgical interventions included removal of diseased tissues, heart chambers treatment with antiseptic solutions, wash out with normal saline solution, replacement or plastic procedure of valves. RESULTS: Heart abscesses were found in 132 (15.5%) patients. Hospital mortality was after aortic valve replacement 12.6%; mitral valve replacement 9.7%; plastic procedure on mitral valve 0%; aortic and mitral valve replacement 30%; tricuspid valve replacement 15.4%; and plastic procedure on tricuspid valve 6.1%. Recurrences of infective process occurred in 51 (6.0%) patients. Infections were observed more frequently in patients with heart abscesses: 10.6% versus 5.7% (p < 0.02). RESULTS: 716 (96.7%) patients were studied 2 to 194 (87.4+/-39.4) months postoperatively. Tenth year postoperative survival was 62.1+/-27.7% including hospital mortality. CONCLUSIONS: (1) AIVE has become one of the most frequent causes of acquired heart lesions in the postChernobyl nuclear power station catastrophe era. (2) Heart failure development in postoperative period is stipulated by the disease duration. (3) Presence of heart abscesses favors recurrence of development of infective endocarditis. (4) Postoperative antibiotic therapy for more than 3 weeks does not help in prevention of recurrences.
机译：背景：传染性心内膜炎的发病率仍然很高：每10万人中3到8例。抗生素治疗无效。其手术治疗经验相对有限。目的：分享在1982年至2000年期间在乌克兰AMS心血管外科研究所接受治疗的855例急性感染性瓣膜性心内膜炎（AIVE）的手术治疗经验。材料与方法：对1128例住院的AIVE患者中的855例进行了手术（占75.4％）。外科手术包括切除病变组织，用消毒液治疗心腔，用生理盐水冲洗，更换瓣膜或整形手术。结果：132例（15.5％）患者发现心脏脓肿。主动脉瓣置换术后住院死亡率为12.6％;二尖瓣置换9.7％;二尖瓣上的塑料程序0％;主动脉和二尖瓣置换30％;三尖瓣置换15.4％;三尖瓣上的塑形操作为6.1％。 51例（6.0％）患者发生感染过程复发。心脏脓肿患者的感染发生率更高：10.6％对5.7％（p <0.02）。结果：716（96.7％）例患者在术后2到194（87.4 +/- 39.4）个月接受了研究。包括医院死亡率在内的术后10年生存率为62.1 +/- 27.7％。结论：（1）AIVE已成为切尔诺贝利核电站后灾难时代后天性心脏病最常见的原因之一。 （2）术后病程由病程决定。 （3）心脏脓肿的存在有利于感染性心内膜炎的复发。 （4）术后抗生素治疗超过3周无助于预防复发。

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