Abstract

During the years 1986 to 1994, 120 patients with a diagnosis of infectious endocarditis (IE) were treated in our Department. There were 55 females and 65 males with a mean age of 44 years. In this group were both patients who developed IE on their natural valves (group A containing 65 patients) and those patients who had previously undergone valve replacement and developed I.E. on prosthetic valves (group B with 55 patients). A diagnosis of I.E. was bacteriologically confirmed in 91 patients (75.9%) from samples of blood and natural or artificial valves taken intraoperatively. In 80.2% of these confirmed cases the infectious agents were Gram-positive bacteria, in 17.6%; they were Gram-negative bacteria and in 2.2% fungi were found. Among the Gram-positive bacteria the most common were coagulase-negative strains of Staphylococcus. Indications for surgical treatment were established on the basis of clinical state, response to pharmacotherapy, echocardiography and bacteriological investigation. All 65 patients from group A (infections found on natural valves) were treated both pharmacologically and surgically. Of the 55 patients in group B, 49 were re-operated and 6 patients were treated only pharmacologically. Altogether, a total of 114 out of the 20 patients underwent a cardiac surgery procedure - 92 of them with good result. Mortality rate was 19.2 %; (15.4%of group A and 24.5% of group B). Combining patients with both surgical and medical treatment, 97 patients had a successful outcome (80.9% survival).

Keywords: infective endocarditis, prosthetic valves endocarditis, surgical treatment, etiological factors