1 From the Department of Surgery and the First Surgical Service of the University Hospital, University of Washington School of Medicine, Seattle, Washington.
Fourteen patients with bacterial endocarditis had open heart surgery. Thirteen were operated upon because of congestive heart failure, and in one the indication for surgery was persistent infection. The aortic valve alone was involved in six patients; two patients had both aortic and mitral valve endocarditis. Five patients had infection of the mitral valve, and one patient had tricuspid valve involvement. All the patients received preoperative antibiotics for a variable period. Ten patients left the hospital and four died in the hospital. Of the 10 patients discharged, one died 9 months later of congestive heart failure. Seven patients developed valvular leaks either through the suture line or the homograft, and two deaths resulted. Nine patients are alive and in good functional status. Antibiotics were given for 5 to 10 days postoperatively; one patient, however, received antibiotics for 49 days. Early open heart surgery is recommended in bacterial endocarditis if heart failure is progressive. Shorter postoperative antibiotic therapy is proposed once the source of residual infection is removed.
Submitted on December 19, 1969
© 1970 American Heart Association, Inc.
Open Heart Surgery in Infective Endocarditis
Key Words: Aortic regurgitation • Paraprosthetic regurgitation • Mitral annuloplasty • Replacement of aortic valve with aortic homograft • Tricuspid regurgitation
Accepted on January 6, 1970