Diagnosis And Surgical Treatment Of Infective Endocarditis: A Report Of 104 Cases

Objective: To summary and analysis the clinical data, perioperative Management, controversy in treatment and recent years` research progressionof valvular heart disease combined with coronary artery disease. Method: Analyzing retrospectively the clinical data, surgical treatment of 31 patients who underwent coronary artery bypass grafting (CABG) associated with heart valve surgery in our hospital from March, 2004 to Novmber, 2009 ?Clinic data The whole group involve 31patients, including 22males, 9female.Age (mean age: 56.3±10.5) .2 patients had a history of rheumatic heart disease for many years, and have angina pectoris in recent years; other 4patients mainly complained about the symptoms of cardiac ischemia combining valvular disease. All patients had coronary artery angiography to confirm the coronary arteries `pathological changes. In addition, 4 patients had angina pectoris, 1 had myocardial infarction, 1 patient had hypertension, 2patients suffer from atrium fibberation . preoperative echocardiography indicated: left ventricle ejection fraction (LVEF) : (58.3%±8.5%) , left ventricle end diastole diameter (LVEDD) : (60.6±12.0mm) . preoperative coronary artery angiography manifested that 9 had single-vessel disease, 15 double-vessel diseases, 2 hadtriple-vessel diseases. Surgical techniques operations were performed under the conditions of whole body anaesthesia, hypothermia (28±2)℃and cardiopulmonary bypass (CPB) .The CPB time was (mean time: 121.5±53.9min) , and the duration of aortic cross-clamping time was 45～130 min. (mean time: 80.6±27.2 min) . All patients were performed operation with cardiopulmonary bypass (CPB) .Results: There were has 4 death. Dopamine were used with thedosage of 5-10μg.kg-.min-1. glonoin with the dosage of 0.1-0.5μg.kg-1.min-1. Conclusion: patients who suffered from valvular heart disease combined with coronary artery disease usually had complicated pathophy siological changes, require high surgical technique to operation, andhave to endure long myocardial ischemic period during the operation. with ahigh early and late mortality. the perioperative managements have itself characteristics, we should earnestly improve and evaluate patients cardiacfunction preoperatively, carefully research the influence of the changing of cardiac preload and afterload, fully estimate patients condition and operation risk; management carefully after operation according to pathophysiological changes.