By Henryk Siniawski
Active infective endocarditis is among the so much severe illnesses of the center. an infection usually motives periannular abscess, and will additionally unfold to impact the mitral valve constructions. This trouble incorporates a excessive mortality cost and valve alternative via in depth care and antibiotic therapy could be the basically choice to store patientsвЂ™ lives. critical hemodynamic melancholy brought on by bacterial surprise, is this present day not a counter-indication, and the second one significant chance issue, that of postoperative reinfection, has been vastly lowered through the use of homografts and new valve prostheses which are immune to bacterial an infection. well timed operation, sooner than advanced destruction of cardiac buildings happens, achieves a miles larger price of survival.
This review of the result of surgical procedure of energetic infective endocarditis used to be played on the German center Institute Berlin. It specializes in preoperative research and proposes a brand new type of this endocarditic disease.
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Aur. Survivors n 1 4 2 3 1 Non-survivors n % 3 43 4 57 - % 9 36 18 27 9 Table 12. 8%) patients who did not survive after surgery. The patients suffering from root abscess complicated by vasoactive shock caused by Enterococci, E. coli and Pseudomonas infection were successfully treated. Three of the four patients with infection caused by Staphylococcus aureus and four of the eight suffering from a Streptococcus infection died postoperatively, indicating that infection caused by these microorganisms was difficult to treat successfully (Table 12).
7 Table 14. 3%) patients suffering from vasoactive shock in whom sole aortic valve replacement was undertaken (Tables 13, 14). 7%) patients. In 13 patients a homograft was inserted in aortic position and only in 5 patients was a stentless aortic valve used. Mitral valve damage was observed in one case as local metastatic disease with destruction of the anterior mitral leaflet. In four cases a jet lesion of the anterior mitral leaflet with pseudoaneurysm formation was found. In all five cases mitral valve replacement (Shelhigh) was undertaken.
20 Jet lesion Destruction of the mitral valve by jet lesion with different stages was observed. A diagram of the inflow and outflow tract of the left ventricle in systole and diastole is presented in Figure 10. At the beginning of jet lesion development color Doppler clearly visualizes the relation of the aortic jet and the anterior leaflet. Ao LA AML Ao LA AML B. Diastole A Systole Figure 10. A ( systole) shows ejection with no remarkable pathological changes visible on damaged area (black arrow).