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Surgical treatment of active infective aortic valve endocarditis with associated periannular abscess--11 year results.

Abstract：

AIMS:The aim of the study was to evaluate the long-term results of allograft and prosthetic valve replacement in the treatment of infective aortic valve endocarditis with periannular abscess. METHODS:Between March 1988 and March 1996, 65 patients underwent surgery for active aortic valve endocarditis and paravalvular abscess. The indications for surgery were congestive heart failure, systemic emboli and atrioventricular block III. The pre-operative evaluation was performed with transoesophageal echocardiography. Aortic valve replacement was performed with allografts in 47 cases, with mechanical valves in 15, and bioprosthetic valves in three cases. All patients with total ventricular-aortic dehiscence and prosthetic valve endocarditis were treated with allografts. RESULTS:The 30-day mortality rate was 23.5% in the prosthetic group, when compared with 8.5% in the patients treated with allografts. The rate of recurrent valve infections during the 11-year follow-up period was 27.1% in the prosthetic group and 3.2% in the allograft group. The actuarial 11-year survival rate was 82.1% in the allograft group and 64.7% in the prosthetic group. CONCLUSION:Aortic allografts are an effective treatment for infective aortic valve endocarditis with associated periannular abscess. The operative mortality and recurrent infection rates are lower than in the prosthetic group, resulting in a significantly higher survival rate. Diagnosis and surgical management of these cases should be based on pre-operative transoesophageal echocardiography.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Knosalla C,Weng Y,Yankah AC,Siniawski H,Hofmeister J,Hammerschmidt R,Loebe M,Hetzer R

doi

10.1053/euhj.1999.1877

subject

Has Abstract

pub_date

2000-03-01 00:00:00

pages

490-7

issue

6

eissn

0195-668X

issn

1522-9645

pii

S0195668X99918778

journal_volume

21

pub_type

杂志文章

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