Prosthetic valve sewing-ring sealing with antibiotic and fibrin glue in infective endocarditis. a prospective clinical study

Abstract

To analyze the benefits of prosthetic valve sewing ring sealing with antibiotic and fibrin glue in endocarditis, a prospective study was undertaken in 16 consecutive patients. Valvular lesions concerned aortic valve in seven patients, mitral valve in three and both in six. Preoperative antibiotic treatment was started 15±15 days before surgery. Peroperative findings showed six isolated valvular lesions and ten perivalvular extensions. Before the prostheses were sutured to the annulus, the Dacron™ sewing rings were covered with antibiotic and fibrin glue. The antibiotic was chosen according to the micro-organism identified preoperatively. We didn't have any peroperative mortality or paravalvular leakage (PVL). One patient died suddenly on postoperative day (POD) nine (non-contributive autopsy). Another patient was reoperated on POD 31 for PVL. Peroperative local bacteriological examinations were sterile. Mean follow-up was of 9.3±6.8 months and was completed in all cases. Actuarial survival rate was 94±6% and freedom from reoperation was 92±7%. Antibiotic treatment was stopped after 59±64 days for 10 patients. None of them had recurrence of endocarditis or PVL. Prosthetic valve sewing ring sealing with adapted antibiotic and fibrin glue can constitute a good weapon in the armamentarium of surgical treatment of active endocarditis. © 2007 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.