Wilcox B R, Murray G F, Starek P J
J Thorac Cardiovasc Surg. 1977 Dec;74(6):860-3.
This study follows the clinical course of 22 patients in the active phase of infective endocarditis who inderwent valve replacement at North Carolina Memorial Hospital between March, 1966, and March, 1976. At the time of operation, there was gross valve tissue destruction in 16 patients, verrucae in nine, ruptured chordae tendineae in five, and myocardial or annular abscess formation in five. Four patients survived less than 6 months after the initial operation. One survived almost 3 years before dying of recurrent carcinoma of the lung. The remaining 17 patients have been followed an average of 4.6 years. Major postoperative complications were as follows: paravalvular problem, five patients; congestive heart failure, seven patients; complete heart block, three patients; systemic arterial emboli, four patients. These complications often were associated with the preoperative presence of annular or myocardial abscess. Thus it appears that postoperative complications often result from annular structural deficiencies rather than being directly related to active infection.
本研究追踪了1966年3月至1976年3月期间在北卡罗来纳大学纪念医院接受瓣膜置换术的22例感染性心内膜炎活动期患者的临床病程。手术时，16例患者有明显的瓣膜组织破坏，9例有赘生物，5例有腱索断裂，5例有心肌或瓣环脓肿形成。4例患者在初次手术后存活不到6个月。1例存活了近3年，最终死于复发性肺癌。其余17例患者平均随访了4.6年。主要术后并发症如下：瓣周问题，5例；充血性心力衰竭，7例；完全性心脏传导阻滞，3例；系统性动脉栓塞，4例。这些并发症常与术前存在瓣环或心肌脓肿有关。因此，术后并发症似乎常由瓣环结构缺陷引起，而非直接与活动性感染相关。
