Asada K, Minohara S, Hasegawa S, Sawada Y, Morimoto T, Matsuyama N, Okamoto J, Irie H
Department of Thoracic Surgery, Osaka Medical College, Takatsuki, Japan.
Kyobu Geka. 1996 Jul;49(8 Suppl):669-72.
Between August 1980 and December 1995, 29 patients have undergone valve replacement for active infective endocarditis (IE) at our institute. Twenty five patients had native valve endocarditis (NVE) and 4 had prosthetic valve endocarditis (PVE). The indication for surgery in 29 patients was congestive heart failure, septicemia or systemic embolization. Twenty six patients had vegetation. Eleven patients had AVRs, including one modified Bentall operation, 10 had MVRs and four had DVRs with mechanical prosthetic valve. There were eleven early death (38%) and one late death. Operative mortality rate has reduced to 24% after 1991. We conclude that early surgical intervention should be taken according to the hemodynamic state of the patients irrespective of the presence of septicemia.
1980年8月至1995年12月期间,我院有29例患者因活动性感染性心内膜炎(IE)接受了瓣膜置换术。25例为自体瓣膜心内膜炎(NVE),4例为人工瓣膜心内膜炎(PVE)。29例患者的手术指征为充血性心力衰竭、败血症或全身性栓塞。26例患者有赘生物。11例患者接受了主动脉瓣置换术(AVR),其中包括1例改良Bentall手术,10例接受二尖瓣置换术(MVR),4例接受双瓣膜置换术(DVR)并植入机械人工瓣膜。有11例早期死亡(38%)和1例晚期死亡。1991年后手术死亡率降至24%。我们得出结论,无论是否存在败血症,都应根据患者的血流动力学状态尽早进行手术干预。