Surgery for bacterial endocarditis: retrospective study of 32 patients

Surgery for active endocarditis is indicated in cases of congestive heart failure (CHF), persistent sepsis, systemic embolization and paravalvular involvement. To assess and report the long term results of surgery in adult patients. Retrospective review of clinical records and operative procedures of 32 patients aged 43+/- 13 years (28 women) subjected to reparative surgery for complications of endocarditis between 1993 to 2005. In 25% of cases, endocarditis presented as a prolonged sepsis syndrome and in 31% as a CHF or both. The causative bacteria was Gram (+) in 53% and blood cultures were negative in 47%. Preoperative echocardiography showed vegetations in 56% of cases. An annular abscess, aortic valve rupture and bicuspid valve, was observed in 13% of patients. Post operative mortality was due to persistent sepsis and multi-organic dysfunction in 16%. Mean long term follow up was 43.8+/-47.2 months. Actuarial survival was 78% at 146 months. Surgical management of active endocarditis provides a good symptomatic recovery, with an excellent long term actuarial survival.