41例感染性心内膜炎的外科治疗

Surgical treatment of infective endocarditis: A report of 41 cases

目的 :总结感染性心内膜炎的特点及外科治疗经验。方法 :回顾性分析 4 1例感染性心内膜炎的外科治疗。其中施行主动脉瓣置换术 2 2例 ,二尖瓣置换术 9例 ,双瓣置换术 4例 ,三尖瓣修复成形术 3例 ,肺动脉瓣成形术 3例。同期矫治合并畸形 ,包括室间隔缺损、房间隔缺损、动脉导管未闭、主动脉窦瘤破裂和右室流出道梗阻。结果 :术后早期死亡 2例 ,病死率 5 %。术后随访 3月～ 5年 (平均 3 2年 ) ,无复发及晚期死亡病例。结论 :外科治疗感染性心内膜炎的死亡率低。尽早手术可避免心肌细胞发生不可逆性损害 。

Objective To study the characteristics and surgical treatment of infective endocarditis. Methods In all patients, surgical treatment was performed including aortic valve replacement in 22, mitral valve replacement in 9, combined aortic and mitral valve replacements in 4, tricuspid valve reconstruction in 3, and pulmonary valve repair in 3. Meanwhile, acomplicated deformities such as ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arterisus (PDA), ruptared aneuryem of the aortic sinus and right centricular outflow tract obstruction were corrected. Results There were 2 early postoperative deaths (an overall hospital mortality of 5%). A follow up of 3 months to 5 years, with a mean of 3.2 years, documented no recurrent endocarditis and late death. Conclusion Low mortality occurs in the surgical therapy for infective endocarditis. In order to avoid irreversible injury on cardiomyocyte, the operation, which is beneficial to the recovery of heart function, should be performed as early as possible.