By Henryk Siniawski
Active infective endocarditis is among the so much severe ailments of the guts. an infection usually explanations periannular abscess, and will additionally unfold to impact the mitral valve constructions. This difficulty contains a excessive mortality expense and valve substitute via extensive care and antibiotic therapy could be the purely choice to store patientsвЂ™ lives. critical hemodynamic melancholy as a result of bacterial surprise, is this day now not a counter-indication, and the second one significant probability issue, that of postoperative reinfection, has been drastically lowered by utilizing homografts and new valve prostheses which are proof against bacterial an infection. well timed operation, prior to advanced destruction of cardiac constructions happens, achieves a far better cost of survival.
This overview of the result of surgery of lively infective endocarditis was once played on the German middle Institute Berlin. It makes a speciality of preoperative research and proposes a brand new class of this endocarditic disease.
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Extra resources for Active Infective Aortic Valve Endocarditis with Infection Extension: Clinical Features, Perioperative Echocardiographic Findings and Results of Surgical ... in der Herz-, Thorax- und GefГ¤Гџchirurgie)
In six patients root replacement was undertaken with coronary implantation by the Benthall procedure (Figure 19). 3 1 2 4 Figure 18. Homograft in place. Surgical technique: “free-hand”. 1 = homograft, 2 = left ventricular outflow tract, 3 = LA, 4 = right ventricle 1 2 LVOT AO RV Figure 19. Homograft in place implanted as a root replacement. 1 = homograft, 2 = anterior mitral leaflet from left atrium side. 24 Shelhigh aortic valve substitute In 10 patients a Shelhigh No-React conduit (valve with tissue ascending prosthesis) was implanted, all cases in which the root was severely destroyed.
The great majority of the patients were treated for between 3 and 14 days. This means that the beginning period of the medical treatment was considered satisfactory and only clinical worsening or the development of clear criteria for surgery brought patients to cardiac surgery. 113,114,115,116 Thus, careful follow-up is necessary to find the optimal timing for surgery. Value of echocardiography Patients suffering from AIE are poor candidates for heart catheterization because the risk of mobilizing vegetation can be unpredictable, and coronary revascularization was performed only in cases of essential coronary artery disease.
Postgrad Med J 2002;78:385-392. 24. Brouqui P, Raoult D. Endocarditis due to rare and fastidious bacteria. Clin Microbiol Rev 2001;14:177-207. 25. Comparison of in-house and commercial slides for detection by immunofluorescence of immunoglobulins G and M against Bartonella henselae and Bartonella quintana. Clin Diagn Lab Immunol 2002;9:1004-1009. 26. Frebourg NB, Berthelot G, Hocq R, Chibani A, Lemeland JF. Septicemia due to Pasteurella pneumotropica: 16S rRNA sequencing for diagnosis confirmation.