Resumen de Cirugía de la endocarditis infecciosa en un centro regional en Chile: Análisis de casos y resultados en el largo plazo
Juan Carlos Bahamondes, Gustavo Meriño S., Abelardo Silva V, Juan Salman A, Ivan Redel, Jean Pierre Droguett G
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)
