초록접수 현황
| 20F-127 | 구연 발표 |
The Clinical Result of Valve Repair Surgery in Active Left-sided Infected Endocarditis
Hongsun Kim¹, Kiick Sung¹, Tae-Gook Jun¹, Wook Sung Kim¹, Ji-Hyuk Yang¹, Dong Seop Jeong¹, Yang Hyun Cho¹, Suryeun Chung¹, Pyo Won Park²
¹ Departments of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
² Departments of Thoracic and Cardiovascular Surgery, Mediplex Sejong Hospital, Incheon, Korea
Purpose : The clinical role of early surgery in active infective endocarditis (AIE) is becoming more and more important. However, the technique of valve repair is challenging in AIE because the inflamed tissue is fragile. Moreover, the long term benefit of valve repair is still unclear.
Methods : From January 1995 to June 2020, 680 consecutive adult patients underwent cardiac surgery for infective endocarditis. Of these, 158 patients had mitral valve repair or aortic valve repair, and only 115 patients underwent surgery in acute phase. Overall mortality and event-free survival including death, recurrence of infection, and reoperation were retrospectively analysed.
Results : Mean age was 44.5 ± 14.9 years old, and 69 (60.0%) patients were male. Viridans streptococcus was the most common pathogen and was cultured in 37 (32.2%) patients. The mitral valve repair was performed in 102 (88.7%) patients, and prosthetic annuloplasty ring was inserted in 27 (26.5%) patients. The aortic valve repair was performed in 19 (16.5%) patients. Median follow-up time was 42.0 months and 10-year overall survival was 90.6±3.32%. There were no early mortality, but 8 (7.0%) patients died during follow-up period. Ten-year event-free survival was 87.1±3.84%. Two patients suffered recurrence of infection, and 4 patients required reoperation due to progression of valve stenosis or regurgitation.
Conclusion : Valve repair in active left-sided infective endocarditis can be safely performed with favorable long term outcomes. Although technically challenging, it should be considered as primary treatment option if feasible.
Methods : From January 1995 to June 2020, 680 consecutive adult patients underwent cardiac surgery for infective endocarditis. Of these, 158 patients had mitral valve repair or aortic valve repair, and only 115 patients underwent surgery in acute phase. Overall mortality and event-free survival including death, recurrence of infection, and reoperation were retrospectively analysed.
Results : Mean age was 44.5 ± 14.9 years old, and 69 (60.0%) patients were male. Viridans streptococcus was the most common pathogen and was cultured in 37 (32.2%) patients. The mitral valve repair was performed in 102 (88.7%) patients, and prosthetic annuloplasty ring was inserted in 27 (26.5%) patients. The aortic valve repair was performed in 19 (16.5%) patients. Median follow-up time was 42.0 months and 10-year overall survival was 90.6±3.32%. There were no early mortality, but 8 (7.0%) patients died during follow-up period. Ten-year event-free survival was 87.1±3.84%. Two patients suffered recurrence of infection, and 4 patients required reoperation due to progression of valve stenosis or regurgitation.
Conclusion : Valve repair in active left-sided infective endocarditis can be safely performed with favorable long term outcomes. Although technically challenging, it should be considered as primary treatment option if feasible.
책임저자: Kiick Sung
Departments of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
발표자: Hongsun Kim, E-mail : yoursunny@gmail.com