Seifert M, Möller V, Claus T, Hölschermann F, Butter C
Abteilung für Kardiologie, Immanuel Klinikum Bernau und Herzzentrum Brandenburg, Hochschulklinikum der Medizinischen Hochschule Brandenburg, Ladeburger Str. 17, 16321, Bernau, Deutschland.
Abteilung für Herzchirurgie, Immanuel Klinikum Bernau und Herzzentrum Brandenburg, Hochschulklinikum der Medizinischen Hochschule Brandenburg, Ladeburger Str. 17, 16321, Bernau, Deutschland.
Herzschrittmacherther Elektrophysiol. 2019 Jun;30(2):197-203. doi: 10.1007/s00399-019-0618-y. Epub 2019 Apr 10.
Infective endocarditis (IE) as well as septicemia in patients with implanted cardiac devices are severe diseases and diagnosis is often delayed due to a variety of misleading symptoms. Imaging with transesophageal echocardiography (TEE) and also microbiology play a key role in both the diagnosis and management. They are also useful for the prognostic assessment of patients with IE, for follow-up during treatment, during extraction of the implant and after surgery. In addition to antibiotic treatment, removal of the implant is also necessary, at least if vegetation is detected. Not only the removal of the implant but also the underlying cardiac disease, the frequently occurring severe cardiac insufficiency, the advanced age and the not uncommon high degree of fragility of the patients mean that decision making for treatment and management as well as renewed implantation after completion of treatment are a challenge. The optimal treatment is only possible with a close cooperation between various specialist disciplines and should therefore be carried out in experienced centers.
植入心脏装置的患者发生感染性心内膜炎（IE）以及败血症是严重疾病，由于各种误导性症状，诊断往往延迟。经食管超声心动图（TEE）成像以及微生物学在诊断和管理中都起着关键作用。它们对于IE患者的预后评估、治疗期间、植入物取出期间及手术后的随访也很有用。除抗生素治疗外，至少在检测到赘生物时，移除植入物也是必要的。不仅植入物的移除，而且潜在的心脏病、频繁出现的严重心脏功能不全、高龄以及患者中并不罕见的高度脆弱性，都意味着治疗和管理的决策以及治疗完成后的重新植入是一项挑战。只有各专科密切合作才能实现最佳治疗，因此应在经验丰富的中心进行。
