原发性感染性心内膜炎瓣膜损害的外科治疗(附12例报告)

目的 总结12例原发性感染性心内膜炎(PIE)所致瓣膜损害的外科治疗经验。方法 12例PIE患者中主动脉瓣受损者6例,主动脉瓣和二尖瓣同时受损者2例,三尖瓣受损者2例,主动脉瓣受损合并室间隔缺损2例。12例俱于低温体外循环下行病灶清除术 瓣膜置换术或成形术。结果 术后死亡1例,随访10例,随访时间3～32月,平均23.1月,心功能情况良好。结论 及时手术治疗是挽救PIE瓣膜损害的有效方法,只要手术方法正确,抗生素应用合理,则手术疗效满意。

Surgical Treatment for Cardiac Valve Lesions of Promary Infective Endocarditis

Objective To summarize the experience of 12 surgically treated cardiac valvular lesionsdue to primary infective endocarditis(PIE). Methods Surgical intervention was performed, includingaortic valve replacement in8,combined aortic and mural valve replacement in 2,tricuspid valve recon-struction in 2,and combined AVR and VSD repair in 2.Debridements and valve surgical treatment in all 12cases. Results 1 patient died post operation.The operative mortality was 8.3%(1/12), 10 cases werefollowed up in 3-32 monthes(mean 23.3 monthes).They are very well in good cardiac function. ConclusionCardiac valvular lesions caused by PIE should be treated surgically in most of the time .Operativeresults would be satisfactory if the surgical procedures were suitable and the antibiotic treatment wasrational.