scholarly journals Modified Commando Procedure in Complicated Infective Endocarditis - A Case Series.

Author(s):  
Po Sung Chen ◽  
Chungyi Chang ◽  
Yicheng Chuang ◽  
Ichen Chen ◽  
Tingchao Lin

Abstract Background: Complicated infective endocarditis (IE) with perivalvular abscess and destruction of intervalvular fibrous body (IFB) has high mortality risk and requires emergent or urgent surgery mostly. Case presentation: We presented four patients with complicated infective endocarditis combined with perivalvular abscess and IFB destruction. Three patients had prosthetic valve endocarditis and one patient had native valve endocarditis. They all received modified Commando procedure successfully. No surgical mortality or re-exploration for bleeding. Conclusions: We suggest that modified Commando procedure may have some benefit in improving survival rate of patients with complicated IE and reducing complications.

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Posung Chen ◽  
Chungyi Chang ◽  
Yicheng Chuang ◽  
Ichen Chen ◽  
Tingchao Lin

Abstract Background Complicated infective endocarditis (IE) with perivalvular abscess and destruction of intervalvular fibrous body (IFB) has high mortality risk and requires emergent or urgent surgery mostly. Case presentation We presented four patients with complicated infective endocarditis combined with perivalvular abscess and IFB destruction. Three patients had prosthetic valve endocarditis and one patient had native valve endocarditis. They all received modified Commando procedure successfully. No surgical mortality or re-exploration for bleeding. Conclusions We suggest that modified Commando procedure may have some benefit in improving survival rate of patients with complicated IE and reducing complications.


2020 ◽  
Vol 21 (12) ◽  
pp. 1140-1153 ◽  
Author(s):  
Mohammad A. Noshak ◽  
Mohammad A. Rezaee ◽  
Alka Hasani ◽  
Mehdi Mirzaii

Coagulase-negative staphylococci (CoNS) are part of the microbiota of human skin and rarely linked with soft tissue infections. In recent years, CoNS species considered as one of the major nosocomial pathogens and can cause several infections such as catheter-acquired sepsis, skin infection, urinary tract infection, endophthalmitis, central nervous system shunt infection, surgical site infections, and foreign body infection. These microorganisms have a significant impact on human life and health and, as typical opportunists, cause peritonitis in individuals undergoing peritoneal dialysis. Moreover, it is revealed that these potential pathogens are mainly related to the use of indwelling or implanted in a foreign body and cause infective endocarditis (both native valve endocarditis and prosthetic valve endocarditis) in patients. In general, approximately eight percent of all cases of native valve endocarditis is associated with CoNS species, and these organisms cause death in 25% of all native valve endocarditis cases. Moreover, it is revealed that methicillin-resistant CoNS species cause 60 % of all prosthetic valve endocarditis cases. In this review, we describe the role of the CoNS species in infective endocarditis, and we explicated the reported cases of CoNS infective endocarditis in the literature from 2000 to 2020 to determine the role of CoNS in the process of infective endocarditis.


ESC CardioMed ◽  
2018 ◽  
pp. 1720-1723
Author(s):  
José A. San Román ◽  
Javier López

Prosthetic valve endocarditis (PVE) complicates the clinical course of 1–6% of patients with prosthetic valves and it is one of the types of infective endocarditis with the worst prognosis. In early-onset PVE (that occurs within the first year after surgery), the microbiological profile is dominated by staphylococci. In late-onset PVE, the microorganisms are similar to native valve endocarditis. Clinical manifestations are very variable and depend on the causative microorganism. The diagnosis is established with the modified Duke criteria although they yield lower diagnostic accuracy than in native valve endocarditis. Transoesophageal echocardiography is the main imaging technique in everyday clinical practice in PVE as the sensitivity is higher than transthoracic echocardiography. The findings of other techniques, as cardiac computed tomography (CT), positron emission tomography/CT, or single-photon emission computed tomography/CT have been recently recognized as new major diagnostic criteria and can be very useful in cases with a high level of clinical suspicion and negative echocardiography. Empirical antibiotic treatment should cover the most frequent microorganisms, especially staphylococci. Once the microbiological diagnosis is made, the antibiotic treatment is similar to native valve infective endocarditis, except for the addition of rifampicin in staphylococcal PVE and a longer length (up to 6 weeks) of the treatment. Surgical indications are also similar to native valve endocarditis, heart failure being the most common and embolic prevention the most debatable. Prognosis is bad, and during the follow-up, a team experienced with endocarditis is needed. Patients with a history of PVE should receive antibiotic prophylaxis if they undergo invasive dental manipulations.


2018 ◽  
Vol 54 (6) ◽  
pp. 1067-1072 ◽  
Author(s):  
Makoto Mori ◽  
Kayoko Shioda ◽  
Max Jordan Nguemeni Tiako ◽  
Syed Usman Bin Mahmood ◽  
Abeel A Mangi ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Carlo Rostagno ◽  
Enrico Carone ◽  
Alessandra Rossi ◽  
Gian Franco Gensini ◽  
Pier Luigi Stefano

Background. Aim of present investigation was to analyze survival and recurrence rate in patients with active endocarditis referred to our centre for surgical treatment. Methods. 80 consecutive patients with active infective endocarditis (52 males, 28 females, mean age 59.2 years) were referred to our institution for surgical treatment. 78 patients underwent surgery, and 2 patients died before intervention. Results. Fifty patients had native valve endocarditis, 30 prosthetic valve involvement. Hospital mortality has been 10.2%. Three discharged patients (4.9%) died at an average 18-month followup. Endocarditis recurred in 4 (2 being S. aureus prosthetic tricuspid endocarditis in drug addicts). All patients who underwent valve repair or homograft implant were alive and free of recurrence. Conclusions. Our results suggest that with proper surgical treatment patients with active endocarditis discharged alive from hospital have a survival >90% at 18 months with a low recurrence rate.


2021 ◽  
Vol 24 (3) ◽  
pp. E534-E543
Author(s):  
Hülya YILMAZ AK ◽  
Yasemin ÖZŞAHİN ◽  
Mehmet Ali YESILTAS ◽  
İsmail HABERAL ◽  
Serkan KAHRAMAN ◽  
...  

Background: Infective endocarditis (IE) is a heterogenous infection that affects the endothelial surface of the intracardiac structures and other implanted intracardiac devices. We aimed to compare demographical characteristics, causative microorganisms, treatment, and prognosis of prosthetic and native valve endocarditis diagnosed in two separate hospitals. Material and methods: Between 2010 and 2020, patients admitted with the diagnosis of IE were retrospectively included in our multicenter study. Patients' demographic and epidemiological data, clinical characteristics, infected intracardiac structure and sort of valve, culprit microorganisms, laboratory findings, treatment manifestations and in-hospital outcomes with a period of 6 months were obtained from an electronic medical record system. Results: A total of 173 consecutive patients had diagnosed IE, 60.1% (104 patients) of them native valve endocarditis (NVE) and 39.8 % (69 patients) of them prosthetic valve endocarditis (PVE).  Baseline demographic properties were not different except hypertension and atrial fibrillation. Patients with prior hypertension were 25% (26 patients) in NVE; 39.1% (27 patients) in PVE and the difference was statistically significant. Septic shock was significantly higher in the PVE group than the NVE group (7.4% versus 1%; P = .036), and also recurrent endocarditis occurred more frequently in the PVE group than the NVE group (8.8% versus 1%; P = .016). Conclusion: In our study, although we detected higher mean age, HT, RDW and atrial fibrillation rates compared with NVE, we did not detect a significant difference in mortality and morbidity.


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