原发性感染性心内膜炎瓣膜损害的外科治疗

目的总结２２例原发性感染性心内膜炎（ＰＩＥ）致瓣膜损害的外科治疗经验。方法心脏瓣膜置换术２０例，主动脉瓣和肺动脉瓣病灶清除及瓣膜成形术１例，三尖瓣病灶清除及瓣膜成形术１例。结果手术死亡率１３．６％，早期人工瓣膜心内膜炎１例（４．５％）。随访１５例，随访率６８．２％，随访时间２～８９个月，平均３５．６个月；发生晚期人工瓣膜心内膜炎１例（６．６％），再次手术出院后半月猝死，死因不明。其余１４例情况良好。结论ＰＩＥ致瓣膜损害时应积极手术治疗。只要手术方法正确，抗菌素应用合理，则手术疗效满意

Surgical Treatment of Cardiac Valve Lesions Caused by Primary Infective Endocarditis

Objective To summarize the experience of 22 surgically treated cardiac valve lesions due to primary infective endocarditis (PIE). Methods The cardiac valve replacement was performed in 20 patients. Debridement and valvuloplasty of aortic and pulmonary valve were performed in one case, and debridement and valvuloplasty of tricuspid valve were performed in another case. Results The operative mortality was 13.6%. Early prosthetic valve endocarditis occurred in one case (4.5%).Fifteen cases were followed up with a follow up rate of 68.2%.The duration of follow up was 2 89 monthes(mean 35.6 monthes).Late prosthetic valve endocarditis occurred in one case on whom aortic valve replacement was performed agains but sudden death occurred in this patient two weeks after discharge from the hospital. The cause of death was unknown. The condition of other 14 cases is very well. Conclusion Cardiac valve lesions caused by PIE should be treated surgically.Operative result is good if operative methods are corrective and the usage of antibiotic is rational.