INFECTIVE ENDOCARDITIS - ANALYSIS OF 54 SURGICALLY TREATED PATIENTS

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  • 1 January 1977
    • journal article
    • research article
    • Vol. 73  (1) , 23-30
Abstract
Patients [177] were admitted to the New York University Medical Center [New York, USA] from 1970-1975 with infective endocarditis. Of these paients, 54 required surgical treatment. The over-all mortality rate was 28%. Of the deaths, 2/3 were early (10 patients) and 1/3 late (5 patients). The mortalty rate was 90% in 10 patients treated for 4-6 wk in whom the infection was uncontrolled and the clinical condition was deteriorating. Of the 12 patients with uncontrolled infection who were operated upon promptly within 10 days, 83% survived. The fact that fungal and gram-negative infections responsed poorly to medical therapy suggests the need for prompt, early surgical intervention. The mortality rate in the 32 patients operated upon in whom the infection was controlled was 12.5%. All patients with infective endocarditis who develop progressive congestive failure, recurrent embolization or progressive sepsis, despite treatment, should have prompt valve replacement within 7 days of the institution of appropriate antimicrobial therapy.

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