Crespo Serje L, Espínola Zavaleta N, Romero Cárdenas A, Vargas Barrón J
Departamento de Ecocardiografía, Instituto de Cardiología Ignacio Chávez, INCICH, México, D.F.
Arch Inst Cardiol Mex. 1998 Jul-Aug;68(4):315-21.
Prosthetic valve endocarditis is considered to be associated with more severe prognosis than native valve endocarditis due to inappropriate visualization of vegetations in prosthetics valves by transthoracic echocardiography.
The aim of this study was to describe our experience in prosthetic valve endocarditis and compare our results with those published in the literature. The valve of transesophageal approach in the detection of vegetations and complications associated with endocarditis was also assessed.
30 patients with infective endocarditis of prosthetic valve were studied between 1990 and 1997. The infection was located in prosthetic mitral valve in the 70% of the patients, in the aortic prosthetic valve in 24% and in pulmonary valve in one case. Transoesophageal echocardiography showed only vegetations in 22 patients, vegetations complicated with abscess in six patients and only abscess in 2 patients. In 70% of patients (21) surgical treatment was performed and the 30% (9 patients) received only medical treatment.
Prosthetic valve endocarditis carries worse prognosis than native valve endocarditis, with mortality near 23%. Transoesophageal echocardiography is the indicated approach in the diagnosis of prosthetic valve endocarditis.
由于经胸超声心动图对人工瓣膜赘生物的显示不佳,人工瓣膜心内膜炎被认为比天然瓣膜心内膜炎的预后更严重。
本研究的目的是描述我们在人工瓣膜心内膜炎方面的经验,并将我们的结果与文献中发表的结果进行比较。还评估了经食管途径在检测赘生物和与心内膜炎相关并发症方面的作用。
1990年至1997年间对30例人工瓣膜感染性心内膜炎患者进行了研究。70%的患者感染位于人工二尖瓣,24%位于人工主动脉瓣,1例位于肺动脉瓣。经食管超声心动图显示,22例患者仅有赘生物,6例患者赘生物合并脓肿,2例患者仅有脓肿。70%的患者(21例)接受了手术治疗,30%(9例)仅接受了药物治疗。
人工瓣膜心内膜炎的预后比天然瓣膜心内膜炎更差,死亡率接近23%。经食管超声心动图是诊断人工瓣膜心内膜炎的首选方法。