SURGICAL TREATMENT OF INFECTIOUS ENDOCARDITIS

Abstract

Infectious endocarditis is one of extremely dangerous diseases. Despite the opportunities of modern medicine, hospital mortality in infectious endocarditis remains high. Most patients are operated on for urgent and emergency indications. the article presents 11 years of experience in surgical treatment of infectious endocarditis at the State Budgetary Healthcare Institution JSC "PGKB named after E.E. Volosevich" in the town of Arkhangelsk. the study included 169 patients with infectious endocarditis, verified based on the presence of criteria corresponding to the modified Duke criteria. Infectious endocarditis of native valves (group I) was compared to prosthetic endocarditis (group II). the operative risk according to the EuroScore I, II and STS scales was significantly higher in the group of patients with prosthetic infectious endocarditis (p < 0.001). Para-valve destructive changes were more common (p = 0.05) in the group of prosthetic infectious endocarditis. There were no statistically significant differences in the localization of infectious endocarditis (p > 0.05), however, multiple valve lesions were more often observed in infectious endocarditis of native valves (p = 0.05). a complicated postoperative period was detected in 41.9% of patients of group I and in 71.4% of group II (p = 0.05). Hospital mortality in group I was 3.4%, in group II – 9.5% (p < 0.001). the main cause of death in the postoperative period was acute cardiovascular insufficiency. Despite the fact that hospital mortality in the surgical treatment of active infectious endocarditis continues to be high, surgical intervention in active infectious endocarditis is the only effective method of treatment.