감염성 심내막염의 임상적 고찰

초록

Background: The indications and the optimal time of surgery of infective endocarditis are controversial. We report the surgical results of our hospital during the last 10 years with literature review. Material and Method: Between January 2000 and December 2009, we enrolled 23 infective endocarditis patients who underwent surgery, and analyzed retrospectively. In the preoperative blood culture, 8 cases (34.8%) were positive. The average preoperative antibiotics treatment period was 20.78±16.00 days. There were 12 (52.2%) urgent operations. The average follow up period was 49.26±33.21 months. Result: 20 mechanical valve replacements were performed, 9 in aortic position,8 in mitral position and 3 in the both positions. The other procedures were one mitral valvuloplasty, one infected myxoma extirpation, and one infected pacemaker lead removal with debridement. The average period of postoperative intravenous antibiotic treatment was 24.39±15.98 days. There were 5 complications, including 2 cases of postoperative bleeding, one postcardiotomy syndrome, one cerebral ischemia, and a low cardiac output syndrome. There were statistically significant postoperative improvement in NYHA class, left ventricle end diastolic/end systolic volume, and left atrium size (p-value＜0.05). Conclusion: We could obtain the satisfactory results without any mortalities by using sufficient preoperative antibiotics in hemodynamically stable patients, and by prompt surgery in unstable patients.

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