Retrospective Analysis Of Clinical Effect Of Surgical Treatment Of Infective Endocarditis

Objective:To explore the clinical effect of surgical treatment of infective endocarditis.Methods:The clinical data of 43 patients with infective endocarditis from June 2009 to December 2019 were collected.By consulting the medical records to collect the relevant information of the patients,including general conditions,clinical manifestations,basic cardiac history,echocardiographic manifestations,surgical methods,postoperative ICU,hospital stay,postoperative complications and so on,the data were recorded,sorted out,and compared and analyzed.According to the relevant guidelines and literature reports,whether the patients completed routine drug anti-infective treatment for 4 to 6 weeks from admission to operation were divided into two groups: group A and group B.Group A(n=23): anti-infection was completed 4-6 weeks before operation.Group B(n=20):anti-infection was performed 2-3 weeks before operation.The principle of medical treatment of the patients is the same,and the mode of operation is chosen according to the specific conditions during the operation.All patients were sent to cardiothoracic surgery intensive care unit after operation,and when the condition was stable,they were transferred back to general ward for treatment.Results:Forty-three patients in the whole group completed the operation and there was no death.Mitral valve replacement was performed in 14 cases,mitral valve repair in 13 cases,double valve replacement in 7 cases,aortic valve replacement plus mitral valve repair in 8 cases,and aortic valve replacement in 1 case.The positive rate of blood culture was 34.9%,mainly Streptococcus.The ICU treatment time and postoperative hospital stay in group B were longer than those in group A,but the total hospital stay in group B was shorter than that in group A(P < 0.05).There was no significant difference in the incidence of postoperative complications and recurrence rate within 1 year between group An and group B.One case was complicated with cervical perivertebral infection,and the medical treatment was not improved.After cardiac surgery,further medical treatment was completely recovered.Conclusion:Active surgical treatment can effectively reduce the mortality of IE and improve the prognosis of patients.The risk of early operation is controllable and safe,which can improve cardiac function,reduce the risk of embolism,and provide opportunities for valve repair and improve the quality of life for many patients.IE has a definite clinical effect in the active stage of mitral valve repair.In addition to acute and severe complications,extracardiac infection is mainly treated conservatively,and cardiac surgery is performed first for those with poor curative effect.