Right-sided infective endocarditis: surgical management

Right-sided infective endocarditis (RSIE) accounts for 5-10% of all cases of infective endocarditis and is predominantly encountered among injecting drug users (IDUs). RSIE diagnosis requires a high index of suspicion as respiratory symptoms predominate. Prognosis of isolated RSIE is favourable, and...

Full description

Saved in:
Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2012-09, Vol.42 (3), p.470-479
Main Authors: Akinosoglou, Karolina, Apostolakis, Efstratios, Koutsogiannis, Nikolaos, Leivaditis, Vassilios, Gogos, Charalambos A.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cardiac Surgical Procedures - methods
Cardiac Surgical Procedures - mortality
Cardiology. Vascular system
Echocardiography, Doppler
Education, Medical, Continuing
Endocardial and cardiac valvular diseases
Endocarditis, Bacterial - diagnostic imaging
Endocarditis, Bacterial - etiology
Endocarditis, Bacterial - mortality
Endocarditis, Bacterial - surgery
Female
Heart
Heart Atria - physiopathology
Heart Valve Diseases - diagnostic imaging
Heart Valve Diseases - microbiology
Heart Valve Diseases - surgery
Heart Valve Prosthesis Implantation - methods
Heart Valve Prosthesis Implantation - mortality
Heart Ventricles - physiopathology
Humans
Male
Medical sciences
Middle Aged
Pneumology
Prognosis
Pulmonary Valve - physiopathology
Pulmonary Valve - surgery
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Risk Assessment
Severity of Illness Index
Substance Abuse, Intravenous - complications
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Survival Rate
Treatment Outcome
Tricuspid Valve - physiopathology
Tricuspid Valve - surgery
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Right-sided infective endocarditis (RSIE) accounts for 5-10% of all cases of infective endocarditis and is predominantly encountered among injecting drug users (IDUs). RSIE diagnosis requires a high index of suspicion as respiratory symptoms predominate. Prognosis of isolated RSIE is favourable, and most cases (70-80%) resolve following antibiotic administration. Surgical intervention is indicated in patients with persistent infection that does not respond to antibiotic therapy, recurrent pulmonary emboli, intractable heart failure and if the size of a vegetation increases or persists at >1 cm. Techniques can be divided into 'prosthetic' (valve replacement or prosthetic annular implantation) or 'non-prosthetic' ones (Kay's or De Vega's annuloplasty, bicuspidalization or valvectomy). In IDUs who run a high risk of complications, vegetectomy and valve repair, avoiding artificial material should be considered as the first line of surgical management as is associated with better late survival.
ISSN:1010-7940
1873-734X
DOI:10.1093/ejcts/ezs084