THỰC TRẠNG PHẪU THUẬT VIÊM NỘI TÂM MẠC NHIỄM KHUẨN TẠI VIỆN TIM MẠCH BỆNH VIỆN BẠCH MAI TỪ 2017 – 2024

Abstract

Objectives: 1. to summarize the characteristics of patients with infective endocarditis requiring cardiac surgery at the Cardiovascular Institute of Bach Mai Hospital in the period of 2017-2024 and 2. to identify some factors affecting the results of inpatient treatment after cardiac surgery. Methods: retrospective review of medical records and prospective study. Results: 180 patients, age 47.6 ± 14.9, 72.2% male, 27.2% of patients with known valvular heart disease. Mitral valve lesions 62.8%, aortic valve 42.2%, tricuspid valve 11.7%, pulmonary valve 1.1%. 132 patients had blood culture results, 41.6% of patients were found to have pathogenic bacteria, mainly Gram-positive bacteria (94.6%), streptococci 44%, staphylococci 23.5%. Gram-negative bacteria 5.5%. The average time from admission to surgery was 18.3 days. Urgent and emergency surgery accounted for 14.4%. Valve replacement surgery was 89.4%, valve repair 10.6%, biological valve replacement 47.7%, mechanical valve 41.1%. Patients who progressed well and were discharged had lower Euroscore II scores (4.7 ± 4.6 and 9.9 ± 9.7; p< 0.01) and shorter aortic root occlusion time during surgery (62.6 ± 36.9 min. and 84.9 ± 32.2 min., p< 0.03). Conclusion: Patients mainly had left-sided valvular infective endocarditis, often caused by Gram-positive bacteria, with streptococci predominating. The negative factors affect postoperative prognosis are high EuroScore II score and prolonged intraoperative aortic root coupling time