SURGICAL-TREATMENT OF ACTIVE INFECTIVE ENDOCARDITIS - EARLY AND LATE RESULTS OF ACTIVE NATIVE AND PROSTHETIC VALVE ENDOCARDITIS

The purpose of this study was to determine the clincal predictors of a ctive infective endocarditis in 45 cases we treated between January 19 71 and August 1991 (30 native valve endocarditis (NVE) and 15 prosthet ic valve endocarditis (PVE), The indication of surgery in 45 patients was progressive congestive heart failure (CHF), septicemia and systemi c embolization. The aortic valve was involved in 24 (53%) of 45 patien ts (13 of 30 NVE and 11 of 15 PVE) and there was significantly higher early mortality in aortic PVE (36%) than in aortic NVE (8%). The 9 pat ients with severe cardiac failure (NYHA Class V) before surgery were a ssociated with a significantly higher incidence of early mortality (5/ 9=56%) than those in Class III(2/14=14%) and Class IV(3/18=17%). We co ncluded that aortic valve infection is more prevalent than mitral valv e infection and is more often associated with staphylococcus infection , including abscess formation. Early surgical intervention should be p erformed despite the risk of cardiac failure and extensive infection.