Surgical treatment of infective endocarditis

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Abstract: for patients with valvular heart disease, infective endocarditis is far from perfect, but if once suffered from infective endocard

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Abstract: for patients with valvular heart disease, infective endocarditis is far from perfect, but if once suffered from infective endocarditis, it must be timely treatment, can not delay the timing of treatment.

For patients with valvular heart disease, it is better to stay away from infective endocarditis, but if you suffer from infective endocarditis, then must be treated in a timely manner, can not delay the treatment time. In recent years, with the development of surgical treatment, the mortality of infective endocarditis has been reduced, especially in patients with heart failure.

Surgical treatment of 1, natural valve endocarditis is mainly refractory heart failure; other drugs can not control the infection, especially fungi and antibiotic resistant gram negative bacteria endocarditis; multiple embolism; suppurative complications such as purulent pericarditis, Valsalva sinus aneurysm (bacteria or rupture), ventricular septal myocardial perforation, abscess. When there is complete or high degree atrioventricular block, temporary cardiac pacing can be given, and permanent cardiac pacing is necessary.

2. The mortality of patients with prosthetic valve endocarditis was higher than that of natural valve endocarditis. The mortality rate of PVE treated with antibiotics alone was 60%, and the mortality rate was reduced to about 40% by using antibiotics and artificial valve reoperation. So once suspected PVE should be at least 3 times within a few hours after the blood culture using at least two antibiotics. Most of the early PVE pathogens are highly invasive, and generally advocate early surgery. Most of the latter PVE is caused by Streptococcus, appropriate medical treatment. Fungal PVE medical treatment only as a surgical emergency replacement of the operation of the auxiliary operation, should be early replacement valve. Drug resistant gram negative bacilli PVE is also suitable for early surgical treatment. In other cases, such as valvular dysfunction, moderate or severe congestive heart failure, valvular destruction of the valve or the valve flap and valve stenosis, and new conduction block. Refractory infection, repeated peripheral embolization, should consider the replacement of infected artificial valve.

3, most of the right side of the heart of the drug treatment can receive good results, and because of the right ventricle of the three cusps and pulmonary valve function is not well tolerated, generally do not consider surgical treatment. Medical treatment is ineffective, progressive heart failure and associated with Pseudomonas aeruginosa and fungal infections often require surgical removal of the three cusp.

In order to reduce the residual infection rate after the operation, the patients should continue to use the vitamin 4 to 6 weeks after operation.

If the patients with valvular heart disease who suffered from infective endocarditis, so please don't panic, now the medicine has developed more and more, must have the confidence of cure, and actively cooperate with medical treatment, believe they can overcome the disease and restore health. A good attitude is half the success, in any case have a good attitude.

Keywords: infective endocarditis

 

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