Yapay kalp kapağı endokarditinde cerrahi tedavinin önemi
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Date
1984
Authors
Yiğiter, Besim
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Yapay kalp kapağı endokarditine bağlı ölümler uygun antibiotik kullanarak azaltıldı, fakat hiçbir zaman % 50'nin altına indirilemedi. Seyrek fakat çok ciddi yapay kapak komplikasyonu olan bu enfeksiyonun tedavisinde çoğu zaman cerrahi girişim en etkili yöntem olmaktadır. Bunun değerini araştırmak için merkezimizde 1975-1983 yılları arasında karşılaşılmış 24 yapay kapak endokarditi olgusu incelendi. 8 hasta medikal 16 hasta cerrahi tedavi gördü. Cerrahi tedavi gören 16 hastanın 7'sine erken (8 haftadan kısa antibiyotik tedavisini takiben) 9 'una ise geç (8 haftadan uzun süren medikal tedaviden sonra) müdahale edildi. Medikal tedavi gören grupta mortalite % 62,5 (5/8), geç cerrahi girişim yapılan grupta % 44,4 (4/9) ve erken cerrahi girişimde bulunulan grupta ise % 14,3 (1/7) olarak bulundu. Bu sonuçlar göstermektedir ki; yapay kalp kapağı endokarditinde en seçkin yol cerrahi tedavidir ve cerrahi tedavi erken dönemde yapıldığı takdirde sonuç daha yüz güldürücü olmaktadır.
Despite the availability of new and patented antibiotics, the most successful medical treatment of prosthetic valve endocarditis showed a survival rate of not more than 50 %. Surgical treatment is frequently required in this uncommon but serious complication. The purpose of this review is to examine the objectives of surgical management of prosthetic valve endocarditis and to define the efficacy of this type of treatment when it is applied earlier in the course of the disease. We reviewed cases of prosthetic valve endocarditis in 24 patients who underwent valve replacement at our Center. Of the 8 patients treated medically, 5 (62,5 %) died during the hospitalization. Patients in the surgical group were classi{ied into two subgroups. The mortality rate for Iate surgical subgroup (the patients in this subgroup underwent surgical treatment, after initial antibiotic therapy longer than 8 weeks) was 44,4 % (4/9) and early surgical subgroup (the patients in this subgroup underwent surgical treatment, following not longer than 8 weeks antibiotic therapy) 14,3 (1/7). These findings emphasize the high medical mortality and moderately high surgical mortality in Iate surgical subgroups, suggesting that delayed operative intervention may be a major causative factor resulting in a high surgical mortality. Earlier surgical intervention resulted in higher survival rate.
Despite the availability of new and patented antibiotics, the most successful medical treatment of prosthetic valve endocarditis showed a survival rate of not more than 50 %. Surgical treatment is frequently required in this uncommon but serious complication. The purpose of this review is to examine the objectives of surgical management of prosthetic valve endocarditis and to define the efficacy of this type of treatment when it is applied earlier in the course of the disease. We reviewed cases of prosthetic valve endocarditis in 24 patients who underwent valve replacement at our Center. Of the 8 patients treated medically, 5 (62,5 %) died during the hospitalization. Patients in the surgical group were classi{ied into two subgroups. The mortality rate for Iate surgical subgroup (the patients in this subgroup underwent surgical treatment, after initial antibiotic therapy longer than 8 weeks) was 44,4 % (4/9) and early surgical subgroup (the patients in this subgroup underwent surgical treatment, following not longer than 8 weeks antibiotic therapy) 14,3 (1/7). These findings emphasize the high medical mortality and moderately high surgical mortality in Iate surgical subgroups, suggesting that delayed operative intervention may be a major causative factor resulting in a high surgical mortality. Earlier surgical intervention resulted in higher survival rate.
Description
Keywords
Yapay kalp kapağı, Endokarditinde cerrahi, Surgery in endocarditis, Artificial heart valve
Citation
Yiğiter, B. (1984). ''Yapay kalp kapağı endokarditinde cerrahi tedavinin önemi''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 11(1), 105-110.