Early clinical results of surgical treatment of active infective endocarditis

Abstract

Objectives: In this study, we present early results of surgery in patients who were surgically treated for active infective endocarditis (IE). Patients and methods: Between October 2015 and June 2020, a total of 28 patients (21 males, 7 females; mean age: 62±9 years; range: 46 to 78 years) with an active IE who were not previously operated were retrospectively analyzed. The diagnosis of IE was made on the basis of clinical and transthoracic echocardiographic findings, and microbiological growth in the blood culture. The patients were divided into two groups according to the type of surgery [Group 1 (valve replacement group; n=21) and Group 2 (valve repair; n=7)]. Baseline and operative data of the patients were compared. Results: The median follow-up was 3.4 (range: 2-5 yeras) years. Blood cultures were positive in 19 (67.8%) patients. Coagulase-negative Staphylococci, Staphylococcus epidermidis, and methicillin-resistant Staphylococcus aureus were the most common microorganisms. The main symptoms were fever, fatigue, shortening of breath, and dyspnea. We performed an urgent surgery in six patients who had congestive heart failure resistant to medical treatment (n=2) and pulmonary embolic events (n=4). If there were perivalvular abscess formation, and multiloculated mobile and large vegetations in patients with sepsis or hemodynamic instability despite intense medical treatment including inotropic administration, we preferred early surgery. The postoperative mortality rate was 10.7%. Conclusion: Our study results suggest that active IE is associated with high mortality rates. Valve repair may be chosen in eligible patients after the extensive resection of infected leaf lets with acceptable results.