Kugelberg J, Eskilsson J, Jögi P, Ståhl E
Scand J Infect Dis Suppl. 1983;41:192-7.
Uncomplicated endocarditis is cured by medical treatment at a rate of 80% (75% 5-year survival rate). If incompensated, only 12% has shown to be curable without surgery. With valve replacement, on the other hand, the rate of success will be 80%. Of those surgically treated cases, less than 10% will develop recrudescent infection. Left heart vegetations predict the risk of congestive heart failure and/or embolism. It is assumed that 7-10 days of efficient antibiotic therapy without effect should lead to surgery. We have made valve replacement in six cases during recent years in staphylococcal endocarditis. The main indication for operation was congestive heart failure, and the valve used was the Björk-Shiley tilting disc. All patients had vegetations on the leaflets. One patient had a mitral insufficiency, and the other five had aortic insufficiency. Two cases were lost within four months after surgery. In general, indications for valve replacement are heart incompensation or vegetations on leaflets.
单纯性心内膜炎通过药物治疗的治愈率为80%（5年生存率为75%）。如果出现失代偿，未经手术治疗仅有12%的患者可治愈。另一方面，进行瓣膜置换术的成功率为80%。在接受手术治疗的病例中，不到10%会发生复发性感染。左心赘生物预示着充血性心力衰竭和/或栓塞的风险。一般认为，有效的抗生素治疗7 - 10天无效就应进行手术。近年来，我们对6例葡萄球菌性心内膜炎患者进行了瓣膜置换术。手术的主要指征是充血性心力衰竭，使用的瓣膜是 Björk - Shiley 倾斜碟瓣。所有患者的瓣叶上均有赘生物。1例患者有二尖瓣关闭不全，另外5例有主动脉瓣关闭不全。2例患者在术后4个月内死亡。一般来说，瓣膜置换术的指征是心脏失代偿或瓣叶上有赘生物。
