Operative Timing and Feasibility of Mitral Valve Repair in Active Infective Endocarditis.

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Tadashi Omoto, Atsushi Aoki, Kazuto Maruta, Tomoaki Masuda
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Abstract

Purpose: We studied the association between operative timing and the feasibility of mitral valve (MV) repair in active infective endocarditis (IE).

Methods: Forty-nine active IE patients who underwent MV operation were classified according to operative timing: within 48 hours (Term I: n = 7), between 3 and 14 days (Term II: n = 22), and ≥15 days (Term III: n = 20). Patient profiles, operative outcomes, and feasibility of MV repair were evaluated. Complexity score and severity score were used to define the feasibility of MV repair depending on the extent of infected lesion and technical difficulties.

Results: There were no differences in basic profile in the three groups. Rate of major complications was higher in Term I (86%) than II (41%, p = 0.031) and III (25%, p = 0.005). In-hospital mortality was also higher in Term I (43%) than II (9%, p = 0.039) and III (5%, p = 0.015). The three groups did not differ by feasibility of MV repair calculated by the two-score system or by frequency of MV repair (I: 57%, II: 59%, and III: 55%).

Conclusions: Morbidity and mortality were high in urgent cases. Feasibility of MV repair is associated with the extent of infected lesion and technical difficulties, and not with operative timing.

Abstract Image

Abstract Image

活动性感染性心内膜炎二尖瓣修复术的手术时机和可行性。
目的:我们研究了手术时机与活动性感染性心内膜炎(IE)二尖瓣(MV)修复可行性之间的关系:根据手术时间将接受二尖瓣手术的 49 例活动性 IE 患者分类:48 小时内(I 期:n = 7)、3 至 14 天(II 期:n = 22)和≥15 天(III 期:n = 20)。对患者情况、手术效果和中压修复的可行性进行了评估。根据感染病灶的范围和技术难度,用复杂性评分和严重性评分来定义中风修补术的可行性:结果:三组患者的基本情况无差异。I期(86%)的主要并发症发生率高于II期(41%,P = 0.031)和III期(25%,P = 0.005)。一期(43%)的院内死亡率也高于二期(9%,P = 0.039)和三期(5%,P = 0.015)。根据两评分系统计算的中压修复可行性或中压修复频率,三组没有差异(Ⅰ期:57%;Ⅱ期:59%;Ⅲ期:55%):结论:急诊病例的发病率和死亡率较高。中压修复的可行性与感染病灶的范围和技术难度有关,与手术时机无关。
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来源期刊
Annals of Thoracic and Cardiovascular Surgery
Annals of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-SURGERY
CiteScore
2.80
自引率
0.00%
发文量
56
审稿时长
4-8 weeks
期刊介绍: Information not localized
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