Open Heart Surgery in Infective Endocarditis

Fourteen patients with bacterial endocarditis had open heart surgery. Thirteen were operated upon because of congestive heart failure, and in one the indication for surgery was persistent infection. The aortic valve alone was involved in six patients; two patients had both aortic and mitral valve endocarditis. Five patients had infection of the mitral valve, and one patient had tricuspid valve involvement. All the patients received preoperative antibiotics for a variable period. Ten patients left the hospital and four died in the hospital. Of the 10 patients discharged, one died 9 months later of congestive heart failure. Seven patients developed valvular leaks either through the suture line or the homograft, and two deaths resulted. Nine patients are alive and in good functional status. Antibiotics were given for 5 to 10 days postoperatively; one patient, however, received antibiotics for 49 days. Early open heart surgery is recommended in bacterial endocarditis if heart failure is progressive. Shorter postoperative antibiotic therapy is proposed once the source of residual infection is removed.