Palafox B A, Gazzaniga A B, Thrupp L D, Iseri L T, Conolly J E
Arch Surg. 1976 Jun;111(6):707-10. doi: 10.1001/archsurg.1976.01360240087016.
Infective valvular endocarditis, whether occurring on a native or prosthetic heart valve, continues to carry a serious prognosis. Death is usually due to congestive heart failure, arrhythmia, or embolic complications, rather than infection per se. While antimicrobial therapy and medications to control congestive heart failure continue to be the treatment of choice in most cases, early valve replacement is indicated in certain situations. During the past four years, 12 patients underwent valve replacement for infective endocarditis. Six patients underwent elective valve replacement after antibiotic or antifugal therapy. All survived the operation and were improved. Six other patients underwent emergency valve replacement. Two patients died intraoperatively and their operations, in retrospect, were delayed unnecessarily. Four patients survived and are improved. Prosthetic valve replacement during the course of infective valvular endocarditis should be considered based on indications such as congestive heart failure, rhythm disturbances, etc, rather than the status of the infection.
感染性心内膜炎，无论发生在自身心脏瓣膜还是人工心脏瓣膜上，其预后仍然严重。死亡通常是由于充血性心力衰竭、心律失常或栓塞并发症，而非感染本身。虽然在大多数情况下，抗菌治疗和控制充血性心力衰竭的药物仍是首选治疗方法，但在某些情况下需要早期进行瓣膜置换。在过去四年中，有12例患者因感染性心内膜炎接受了瓣膜置换。6例患者在接受抗生素或抗真菌治疗后接受了择期瓣膜置换。所有患者均存活并康复。另外6例患者接受了急诊瓣膜置换。2例患者术中死亡，回顾其手术，发现手术被不必要地推迟了。4例患者存活并康复。在感染性心内膜炎病程中进行人工瓣膜置换应根据充血性心力衰竭、心律失常等指征来考虑，而非感染状况。
