초록접수 현황
| 15F-161 | 구연 발표 |
Do the Early Surgical Management of Infective Endocarditis Combined Cerebral Septic Embolism Increase the Neurologic Complications?
Do Yeon Kim, Gyun Hyun Jo, Hwan Wook Kim, Joon Kyu Kang, Hyun Song
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Republic of Korea
Background : The incidence of cerebral embolic event in infective endocarditis was about 20~40%. Some treatment guideline of infective endocarditis recommends patients who have the cerebral septic embolism or cerebral hemorrahge should delay surgical management more than 4 weeks. We analyzed the results of neurologic complications according to the presence of cerebral stoke lesions in patients of infective endocarditis after surgical management in this study.
Methods : We studied retrospectively 50 patients with IE, hospitalized between May 2010 and December 2014. Among them, we exclude patients who did not perform brain evaluation and postponed operation more than 7 days because of cerebral embolic infarction. Preoperatively cerebral embolic group were 21 patients and no embolic event group were 20 patients. Among the cerebral embolic patients, 12 patients had combined micro-hemorrhagic lesion in brain study. We analyzed perioperative neurologic outcomes between groups.
Results : Median time to surgery in cerebral embolic group was 5 days. After surgery, intracranial hemorrhage 2 patients (10%) did occur 2 patients (10%) in non embolic group and dif 3patients (14.3%) in embolic group. Postoperative neurologic complications (seizure, delirium, neurologic exacerbations) were not statistically different between the two groups (4 patients, 20.0% vs. 6 patients, 28.6%, p=0.72). Early and late mortality were not also different. In hemorrhagic component combined group, neurologic complication rate (4 patients, 50%) was higher than non hemorrhagic group (1 patient, 8.3%) but there was no statistically significant.
Conclusion : Early surgical management of infective endocarditis is not danger although patients have the cerebral septic embolism. Cerebral hemorrhage components in brain lesion can increase the rate of neurologic problems after operation.
Methods : We studied retrospectively 50 patients with IE, hospitalized between May 2010 and December 2014. Among them, we exclude patients who did not perform brain evaluation and postponed operation more than 7 days because of cerebral embolic infarction. Preoperatively cerebral embolic group were 21 patients and no embolic event group were 20 patients. Among the cerebral embolic patients, 12 patients had combined micro-hemorrhagic lesion in brain study. We analyzed perioperative neurologic outcomes between groups.
Results : Median time to surgery in cerebral embolic group was 5 days. After surgery, intracranial hemorrhage 2 patients (10%) did occur 2 patients (10%) in non embolic group and dif 3patients (14.3%) in embolic group. Postoperative neurologic complications (seizure, delirium, neurologic exacerbations) were not statistically different between the two groups (4 patients, 20.0% vs. 6 patients, 28.6%, p=0.72). Early and late mortality were not also different. In hemorrhagic component combined group, neurologic complication rate (4 patients, 50%) was higher than non hemorrhagic group (1 patient, 8.3%) but there was no statistically significant.
Conclusion : Early surgical management of infective endocarditis is not danger although patients have the cerebral septic embolism. Cerebral hemorrhage components in brain lesion can increase the rate of neurologic problems after operation.
책임저자: Gyun Hyun Jo
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Republic of Korea
연락처 : Do Yeon Kim, Tel: 02-2258-2858 , E-mail : goodmd77@hanmail.net
