Vlessis A A, Khaki A, Grunkemeier G L, Li H H, Starr A
Albert Starr Academic Center for Cardiac Surgery, Providence Health System, Portland, Oregon, USA.
J Heart Valve Dis. 1997 Sep;6(5):443-65.
Prosthetic valve endocarditis (PVE) emerged approximately 37 years ago when the first human heart valve replacements were performed. PVE can be classified as 'early' or 'late' with the pathophysiology and etiologic organisms varying between the two subgroups. The incidence of PVE ranges up to 0.5% per patient-year for mechanical mitral valves and up to 1.0% per patient-year for other valves. The clinical presentation is similar to that of native valve endocarditis, with fever being the most prevalent sign. Diagnosis is based on a constellation of clinical signs and symptoms as well as echocardiographic evaluation of the valve and perivalvular tissues. An algorithm is set forth for diagnosis and management of patients with suspected PVE based on our personal experience and the published literature. Indications for surgery, the surgical approach and methods of PVE prophylaxis and prevention are discussed.
人工瓣膜心内膜炎（PVE）大约在37年前随着首例人工心脏瓣膜置换手术的开展而出现。PVE可分为“早期”或“晚期”，两个亚组的病理生理学和致病微生物有所不同。人工二尖瓣的PVE发病率高达每年每例患者0.5%，其他瓣膜则高达每年每例患者1.0%。临床表现与天然瓣膜心内膜炎相似，发热是最常见的体征。诊断基于一系列临床体征和症状以及对瓣膜和瓣周组织的超声心动图评估。根据我们的个人经验和已发表的文献，提出了疑似PVE患者的诊断和管理算法。讨论了手术指征、手术方法以及PVE的预防和防治措施。
