Surgery in native valve endocarditis: indications, results and risk factors.

摘要: Seventy-nine patients (mean age 49 years) underwent valve replacement or repair for active (58.2%) healed (41.8%) native endocarditis between 1976 and 1992. The most common indication surgery was congestive heart failure (73.4%), followed by multiple systemic emboli (21.5%). Emergency operation necessary in 27.8% of the cases. Operative mortality 3.8% (3 patients) late 15.1% (12 patients). Streptococci were infecting agents (41.8%), Staphylococcus aureus (11.4%). No organisms isolated 27 cases (34.2%). Follow-up spanned 379.8 patient-years with a maximum 15.8 years. Fifteen valve-related events (periprosthetic leak, recurrent endocarditis, thrombo-embolic hemolysis) 20 other complications (anticoagulant-related hemorrhage, arrhythmias failure) occurred 22 patients. linearized rate all is 5.8% per patient-year. influence eight preoperative variables on overall assessed: age, valve(s) affected, infection, bacteriology, annular abscess, emergency elective surgery, renal function NYHA class. Only (P = 0.0012) significant predictor complications. Furthermore, no difference survival found infections.