Cirugía de la endocarditis infecciosa en un centro regional en Chile: Análisis de casos y resultados en el largo plazo

• Juan Carlos Bahamondes ^[2] ; Gustavo Merino S ^[2] ; Abelardo Silva V ^[2] ; Juan Salman A ^[2] ; Iván Redel S ^[1] ; Jean Pierre Droguett G ^[1]
  1. [1] Universidad de La Frontera

     Universidad de La Frontera

     Temuco, Chile

     
  2. [2] Hospital Regional de Temuco Cirugía Cardiovascular
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 136, Nº. 1, 2008, págs. 31-37
• Idioma: español
• Títulos paralelos:
  • Surgery for bacterial endocarditis: Retrospective study of 32 patients
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• Resumen

  • Background: Surgery for active endocarditis is indicated in cases of congestive heart failure (CHF), persistent sepsis, systemic embolization and paravalvular involvement. Aim: To assess and report the long term results of surgery in adult patients. Patients and methods: Retrospective review of clinical records and operative procedures of 32 patients aged 43± 13 years (28 women) subjected to reparative surgery for complications of endocarditis between 1993 to 2005. Results: In 25% of cases, endocarditis presented as a prolonged sepsis syndrome and in 31% as a CHF or both. The causative bacteria was Gram (+) in 53% and blood cultures were negative in 47%. Preoperative echocardiography showed vegetations in 56% of cases. An annular abscess, aortic valve rupture and bicuspid valve, was observed in 13% of patients. Post operative mortality was due to persistent sepsis and multiorganic dysfunction in 16%. Mean long term follow up was 43.8±47.2 months. Actuarial survival was 78% at 146 months. Conclusion: Surgical management of active endocarditis provides a good symptomatic recovery, with an excellent long term actuarial survival (Rev Méd Chile 2008; 136: 31-7)