Brânzan L, Streian C, Popa I P, Cristodorescu R, Rab I
Med Interne. 1985 Oct-Dec;23(4):277-84.
From the 33 patients with infective endocarditis (IE) hospitalized in the 1st Clinic of Internal Diseases, Timişoara between 1981 and 1984, in 5 (4 men and one woman) ranging in age from 21 to 52 years (mean 38) cardiac surgery was indicated and aortic (3) and mitral (2) valve replacements were performed. Valve replacement was performed for: 1) rapid/slow progressive hemodynamic deterioration with intractable congestive heart failure associated with ruptured chordae on posterior leaflet of mitral value (1 case); perforated aortic cusp (1 case); 2) prosthesis endocarditis (1 case); 3) precocious recurrence of IE (1 case); 4) uncontrollable infections (1 case). Echocardiography was helpful in all the cases by permitting recognition and evaluation of the preexistent lesions, and by the supplying of characteristic vegetations (all echocardiographic findings were confirmed by open heart surgery). Likewise it proved an accurate method in assessing pre- and post-operative left ventricular performance. In conclusion it is considered that early valve surgery in IE is indicated in hemodynamic deterioration, prosthetic endocarditis or impossibility to control septicemia. Echocardiography is the most useful noninvasive method for the pre- and postoperative evaluation of the patients investigated.
1981年至1984年间，在蒂米什瓦拉第一内科诊所住院的33例感染性心内膜炎（IE）患者中，有5例（4名男性和1名女性）年龄在21至52岁之间（平均38岁），需要进行心脏手术，并实施了主动脉瓣置换术（3例）和二尖瓣置换术（2例）。进行瓣膜置换的原因如下：1）快速/缓慢进行性血流动力学恶化，伴有难治性充血性心力衰竭，合并二尖瓣后叶腱索断裂（1例）；主动脉瓣穿孔（1例）；2）人工瓣膜心内膜炎（1例）；3）IE早期复发（1例）；4）无法控制的感染（1例）。超声心动图在所有病例中都很有帮助，它能够识别和评估先前存在的病变，并显示出特征性的赘生物（所有超声心动图检查结果均经心脏直视手术证实）。同样，它在评估术前和术后左心室功能方面也是一种准确的方法。总之，认为IE患者在出现血流动力学恶化、人工瓣膜心内膜炎或无法控制败血症时应尽早进行瓣膜手术。超声心动图是对所研究患者进行术前和术后评估最有用的非侵入性方法。
