Raychaudhury T, Cameron E W, Walbaum P R
J Thorac Cardiovasc Surg. 1983 Jul;86(1):112-4.
Operative mortality in patients with prosthetic valve endocarditis (PVE), who already have severe hemodynamic failure, is extremely high (35% to 84%). Over a period of 10 years, between 1972 and 1981, fourteen consecutive urgent operations were performed for PVE in 12 patients. On thirteen occasions the patients were in severe hemodynamic failure (NYHA Functional Class IV), and five of them had early PVE (within 60 days of previous operation). In all patients at least two of the other recognized risk factors, such as presence of non-streptococcal organisms, detachment of the prosthesis, and myocardial invasion, were present. All of the patients but one were operated upon within 48 hours of their hemodynamic deterioration, and there was one postoperative death (operative mortality 7%). Our results indicate that an acceptable surgical mortality in patients with intractable heart failure due to early and late PVE can be achieved by prompt surgical intervention despite the presence of multiple risk factors.
人工瓣膜心内膜炎（PVE）患者若已出现严重血流动力学衰竭，其手术死亡率极高（35%至84%）。在1972年至1981年的10年间，连续对12例患者进行了14次因PVE的紧急手术。13例患者处于严重血流动力学衰竭（纽约心脏协会心功能分级IV级），其中5例为早期PVE（在前次手术60天内）。所有患者均至少存在另外两种公认的危险因素，如非链球菌微生物感染、人工瓣膜脱落和心肌浸润。除1例患者外，所有患者均在血流动力学恶化后48小时内接受手术，术后有1例死亡（手术死亡率7%）。我们的结果表明，尽管存在多种危险因素，但通过及时的手术干预，早期和晚期PVE所致顽固性心力衰竭患者可实现可接受的手术死亡率。
