Surgical treatment of multi-valve heart disease associated with infective endocarditis

Abstract

Objective: The aim of the study was to analyze our own experience of diagnosis, choice of tactics and execution of multi-valve surgical correction of heart defects in infective endocarditis (IE). Methods: We retrospectively analyzed data and clinical results of 156 patients with infective endocarditis who underwent the cardiac surgery in our clinic. Among them, 85 were men (56.5%), and women - 71 (45.5%). Age of our patients ranged from 12 to 68 (mean 32.76 (1.6)) years. The patients were divided into 2 groups: group 1, 89 (57.4%) patients who underwent a complex of developed by the author’s antibiotic therapy, surgical treatment and preventive measures and 2-group 67 (42.6%) patients who underwent the traditional surgical treatment scheme. We analyzed electrocardiography, chest X-Ray, transthoracic echocardiography, transesophageal echocardiography, cardiac catheterization and coronary angiography and blood culture analysis. Results: Intraoperative treatment - preventive measures (TPM) were as follows; mechanical and chemical sanitation of the infected area of the heart; implantation of valves with antibacterial properties; hyperthermic perfusion; antimicrobial therapy, including anti-fungal agents. Application of the above measures reduced mortality in the study group to 5.1%, in the control group - 9.3%. In dynamics, mortality declined to 3.9% in the study group. Conclusion: Our results of surgical treatment of multi-valve heart defects with infective endocarditis showed the efficacy of developed complex preoperative and intraoperative measures in surgical treatment of IE. This new treatment approach is associated with significant improvement of left ventricular function and low mortality rate.

Keywords

• multivalve heart diseases
• infective endocarditis
• complications