先天性心脏病感染性心内膜炎的外科治疗

目的 总结１９９０年３月至１９９８年７月在我院手术治疗的４４例先天性心脏病并发心内膜炎患者的诊断和治疗经验。方法 男３０例，女１４例，平均年龄３１．２岁，血培养２８例，阳性１２例，３７例在感染控制后手术，７例于感染活动期手术。所有病例均彻底清除了感染灶，纠治瓣膜病变及先心病。

Surgical treatment of congenital heart disease complicated with infec tive endocarditis

Objective From March 1990 to July 1998, 44 patients with congenital heart diseases complicated with infective endocarditis underwent cardiac operation. Methods 30 cases were male, 14 cases were female, their mean age was 31.2 years. Blood culture was positive for infection in 12 patients (42.9%). 33 patients underwent cardiac operations after infection was almost controlled and 7 underwent operations during infecting phase. In all cases, infected tissues were excised, valvular dysfunctions were corrected, and congenital cardiac defects were treated. Results 4 patients(9.1%) died during hospitalization. Conclusions 1. In our hospital, the incidence rate of infective endocarditis complicating congenital heart diseases is increasing. Ventricular septal defect, bicuspid aortic valves, patent ductus arteriosus and ruptured aneurysms of the sinus of Valsalva are the most frequent underlying congenital heart diseases. 2. Echocardiography is valuable tool in diagnosis. Blood culture may be negative after previous administration of antibiotics. 3. Aggressive surgical treatment should be adopted in patients with congenital heart defects complicated with infective endocarditis.