Surgical treatment of infective endocarditis

Abstract

PURPOSE--To analyse, retrospectively, 83 patients with infective endocarditis (IE) that were operated during the acute phase of the disease and to identify possible subgroups with distinct mortality. METHODS--Between 1985 to 1990, 83 patients comprised the subject of this analysis. Fifty-one (61%) were male, aged between 3 months to 71 years, mean of 31.4 +/- 16.7 years. RESULTS--We could identify two subgroups that were most frequently operated on: the left side IE and the Staphylococcus aureus; and 77 (43%) had left sided IE (p < 0.001). When discriminated accordingly to the specifically etiologic agent (Staphylococcus aureus) this difference continues to be statistically significant: of 29 left sided IE by this agent 13 (45%) were operated on, whereas from 22 right sided IE by the same agents, just 3 (14%) were operated on (p < 0.05). The two major etiologic agents did not show any statistically significant difference in the number of patients that needed to be operated on: on those 51 patients with Staphylococcus aureus IE, 16 (31%) were treated surgically, while from the 60 patients with Streptococcus viridans, 22 (37%) underwent to surgical procedure (p- NS). The mortality in the patients treated by surgery was 32%, and those with Staphylococcus aureus IE were responsible for 46% of the total surgical deaths. CONCLUSION--Surgical treatment were most frequently used in the patient with left sided IE independently of the etiologic agent.