Jain Ankit, Subramani Sudhakar, Gebhardt Brian, Hauser Joshua, Bailey Caryl, Ramakrishna Harish
Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia & Augusta University, Augusta, GA.
Department of Anesthesiology and Perioperative Medicine, University of Iowa, Iowa City, IA.
J Cardiothorac Vasc Anesth. 2023 Apr;37(4):637-649. doi: 10.1053/j.jvca.2022.12.030. Epub 2023 Jan 6.
Infective endocarditis is a common pathology routinely encountered by perioperative physicians. There has been a need for a comprehensive review of this important topic. In this expert review, the authors discuss in detail the incidence, etiology, definition, microbiology, and trends of infective endocarditis. The authors discuss the clinical and imaging criteria for diagnosing infective endocarditis and the perioperative considerations for the same. Other imaging modalities to evaluate infective endocarditis also are discussed. Furthermore, the authors describe in detail the clinical risk scores that are used for determining clinical prognostic criteria and how they are tied to the current societal guidelines. Knowledge about native and prosthetic valve endocarditis, with emphasis on the timing of surgical intervention-focused surgical approaches and analysis of current outcomes, are critical to managing such patients, especially high-risk patients like those with heart failure, patients with intravenous drug abuse, and with internal pacemakers and defibrillators in situ. And lastly, with the advancement of percutaneous transcatheter valves becoming a norm for the management of various valvular pathologies, the authors discuss an in-depth review of transcatheter valve endocarditis with a focus on its incidence, the timing of surgical interventions, outcome data, and management of high-risk patients.
感染性心内膜炎是围手术期医生经常遇到的一种常见病理情况。一直需要对这一重要主题进行全面综述。在这篇专家综述中,作者详细讨论了感染性心内膜炎的发病率、病因、定义、微生物学及发展趋势。作者讨论了诊断感染性心内膜炎的临床和影像学标准以及与之相关的围手术期注意事项。还讨论了用于评估感染性心内膜炎的其他影像学检查方法。此外,作者详细描述了用于确定临床预后标准的临床风险评分以及它们与当前社会指南的关联。了解自体瓣膜和人工瓣膜心内膜炎,重点是以外科干预时机为重点的手术方法及当前治疗结果分析,对于管理此类患者至关重要,尤其是对于心力衰竭患者、静脉药物滥用患者以及体内有起搏器和除颤器的高危患者。最后,随着经皮经导管瓣膜在各种瓣膜病变管理中成为常态,作者深入讨论了经导管瓣膜心内膜炎,重点关注其发病率、手术干预时机、治疗结果数据以及高危患者的管理。