Surgical therapy of bacterial endocarditis

On the basis of an own clinical material of 26 patients and in comparison to the literature indications and results of the operative therapy in bacterial endocarditis were discussed. The progressive, conservatively not controllable cardiac insufficiency is the most frequent indication for operation. Without valve replacement it causes death in 60-90% of the patients. In contrast to this there is a postoperative early lethality of 10-30%. Among our own patients the early mortality was 19%. Ill patients operated on were in an advanced stage of the disease, seven patients had to be operated on under emergency conditions. Postoperatively, an improvement of the clinical stages by on an average two degrees of severity (NYHA) could be established. For the purpose of a further improvement of the changes of survival in patients with bacterial endocarditis the demands for an early diagnosis, an adequate antibiotic therapy, a well-timed operation and a suitable operating technique have to be fulfilled.