Cirugía valvular reparadora en endocarditis infecciosa
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Ricardo Zalaquett S [1] ; Luis Garrido O [1] ; Francisca Casas R [1] ; Sergio Morán V [1] ; Manuel J Irarrázaval Ll [1] ; Pedro Becker R [1] ; Sandra Braun J [1] ; Samuel Córdova A [1] ; Gastón Chamorro S [1] ; Iván Godoy J [1] ; Fernando Yáñez D [1] ; Jaime Labarca L [1] ; Carlos Pérez C [1]
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[1] Pontificia Universidad Católica de Chile
Pontificia Universidad Católica de Chile
Santiago, Chile
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- Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 132, Nº. 3, 2004, págs. 307-315
- Idioma: español
- Títulos paralelos:
- Valve repair surgery in infectious endocarditis
- Enlaces
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Resumen
Background: Valve replacement has been the treatment of choice for patients with valvular complications of infectious endocarditis (IE). However, excellent results with valve repair allowed it to become a new therapeutic alternative for these patients. Aim: To evaluate the results of valve repair in patients with valvular complications of IE. Patients and Methods: From January 1991 to December 2000, 14 patients with valvular complications of IE underwent valve repair. Mean age was 37.9 ± 14.9. Results: New York Heart Association (NYHA) class was 2.8 ± 0.9. IE was located in the aortic in 6 (42%), in the mitral valve in 4 (29%) and in both valves in 4 cases (29%). Surgical indication was hemodynamic in 50% of the cases, echocardiographic in 29% and septic in 21%. Five aortic valves were bicuspid, 3 mitral valves were myxomatous and the rest were normal. The most common septic lesions were vegetations and leaflet perforations. A total of 23 aortic and 21 mitral valve repair procedures were performed. There were no deaths. Only 1 patient had a surgical complication (renal failure and prolonged mechanical ventilation). Follow-up was 100% complete. There was not late mortality. One patient with bone marrow aplasia required reoperation for a new episode of IE 19 months later. At the end of the follow-up NYHA class was 1.3 ± 0.6 and echocardiography showed a mild or absence of valve regurgitation in most patients. Conclusions: Valve repair surgery in IE has good results, with advantages over valve replacement (Rev Méd Chile 2004; 132: 307-15).
