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Date Published: 25/04/2022
Abstract Views: 249
Views PDF: 122
DOI: https://doi.org/10.51298/vmj.v512i1.2245
Issue
Vol. 512 No. 1 (2022)
Section
Các bài báo
How to Cite
Việt Thắng, Đỗ ., & Quyết Tiến, T. . (2022). EARLY RESULTS OF SURGICAL TREATMENT OF INFECTIVE ENDOCARDITIS. Vietnam Medical Journal, 512(1). https://doi.org/10.51298/vmj.v512i1.2245

EARLY RESULTS OF SURGICAL TREATMENT OF INFECTIVE ENDOCARDITIS

Đỗ Việt Thắng1,, Trần Quyết Tiến2,3
1 115 People’s Hospital, Ho Chi Minh City
2 Cho Ray Hospital
3 Vietnam National University HCMC

Main Article Content

Abstract

Background: Infective endocarditis (IE) is an uncommon cardiovascular disease with a high mortality rate and severe complications. About 50% of patients with IE require surgical treatment because of its severe complications. The goals of surgical treatment are to prevent developing heart failure due to destruction structures in the heart, to prevent spreading infection, and to prevent embolism. Objective: To evaluate the early results of surgical treatment of infective endocarditis. Material and Methods: A retrospective and case series study of patients who underwent surgery to treat IE at Cho Ray hospital from January 2020 to January 2021. Results: 51 patients with an average age of 42.1 (73% male), were diagnosed infective endocarditis with indication for surgery. 86% of cases had severe heart failure NYHA III-IV. 37% of emergency and urgent surgery, 12% of re-operation due to prosthetic valve endocarditis. 6 cases underwent minimally invasive heart surgery through right thoracotomy. There are 26 patients with vegetations on the mitral valve, 15 patients with vegetations on both the mitral valve and the aortic valve, and 6 cases with perivalvular abscess. There were 6 positive blood cultures: 4 cases due to Streptococcus spp., 2 cases due to Staphyloccus. 23 patients with aortic valve replacement, 17 patients with mitral valve replacement, 22 patients with mitral valve repair, 7 patients with Bentall surgery. Post-operative, there were 3 cases of bleeding requiring reoperation, 39 cases requiring at least 1 vasopressor, 1 case of using ECMO, 7 cases of acute renal failure, 3 deaths. The average surgical time was 300 minutes (average aortic clamping time is 101 minutes) and the average postoperative hospital stay was 18.5 days. The surviving patients reported good treatment outcomes at the time of discharge, clinical improvement of heart failure, and no permanent complications. Conclusions: Surgical treatment of IE achieved good early results with postoperative mortality rate of 5.9% related to long operative time, emergency surgery and IE on prosthetic valve. Complications of acute heart failure after surgery are common but respond to medical treatment. There was no permanent complications.

Article Details

Keywords

infective endocarditis, abscess, heart failure, valve repair, valve replacement, Bentall surgery

References

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