[Infectious endocarditis of the heart valves and valvular prostheses. report of 21 cases].

During 1978, and 1979, the Surgery Division of The Cardiology and Pneumology Hospital of The National Medical Center (Mexican Institute for Social Security), studied and treated surgically twenty one cases -- in twenty patients -- of infectious endocarditis. Nine patients had an active infection in the heart valves and twelve in the prosthesis. The survival rate of the first group was 88.88% and of the second group 58.33%. The causes of death were due to the hemodynamic damage that the valvular or prosthetic dysfunction leads to, when there is a delay in the arrival of the patient to a medical unit of third level. The conventional medical treatment applicable to a reduced number of cases whose characteristics are discussed do not operate when dealing with patients with infected prosthesis or valve infections caused by non-gram positive bacteria. We conclude that this problem demands a better approach, principally surgical, to improve the prognosis of these patients.