By Henryk Siniawski
Active infective endocarditis is likely one of the so much severe ailments of the guts. an infection usually motives periannular abscess, and will additionally unfold to impact the mitral valve constructions. This review of the result of surgery of lively infective endocarditis used to be played on the German middle Institute Berlin. It specializes in preoperative research and proposes a brand new type of this endocarditic disease.
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Extra info for Active Infective Aortic Valve Endocarditis with Infection Extension: Clinical Features, Perioperative Echocardiographic Findings and Results of Surgical Treatment
9) 2 2 Table 17. Types of lesion on mitral valve in patients suffering from secondary infective mitral valve disease (SMVD) with primary aortic valve AIE with root abscess and type of mitral valve surgery undertaken 35 (replacement or reconstruction). MVP = mitral valve replacement (prosthesis), MVR = mitral valve reconstruction. 9%) in whom mitral valve reconstruction was first attempted. Failed reconstruction was diagnosed on the basis of intraoperative echocardiography. Two patients with failed reconstruction had metastatic extension and two had jet lesion.
3 1 2 4 Figure 18. Homograft in place. Surgical technique: “free-hand”. 1 = homograft, 2 = left ventricular outflow tract, 3 = LA, 4 = right ventricle 1 2 LVOT AO RV Figure 19. Homograft in place implanted as a root replacement. 1 = homograft, 2 = anterior mitral leaflet from left atrium side. 24 Shelhigh aortic valve substitute In 10 patients a Shelhigh No-React conduit (valve with tissue ascending prosthesis) was implanted, all cases in which the root was severely destroyed. In 21 patients a stentless Shelhigh No-React valve was used.
The proposed new criteria of echocardiographic assessment of active infective endocarditic lesions seem to represent a promising step in applying a more precise treatment concept. Great emphasis has to be placed on the complications that can develop. The optimistic conclusion of this piece of work is that this disease, if treated in time, can have an acceptably low mortality. On the other hand, destructive endocarditis complicated by shock is associated with a substantial mortality rate and should be treated surgically without delay.
Active Infective Aortic Valve Endocarditis with Infection Extension: Clinical Features, Perioperative Echocardiographic Findings and Results of Surgical Treatment by Henryk Siniawski