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  • Title: [Aortic homograft implantation in severe endocarditis].
    Author: Foghsgaard S, Bruun NE, Kjaergård HK.
    Journal: Ugeskr Laeger; 2008 May 05; 170(19):1646-50. PubMed ID: 18489875.
    Abstract:
    INTRODUCTION: Severe endocarditis of the native aortic valve or a prosthetic valve with destruction of the cusps, paravalvular abscess formation and/or fistulas caused by aggressive bacteria has a mortality of almost 100% without surgery. The objective was to evaluate the results of treatment with an aortic homograft in combination with antibiotics. MATERIALS AND METHODS: 24 patients with either aortic prosthetic valve endocarditis (n = 16) or severe aortic endocarditis (n = 8) were operated with implantation of an aortic homograft at a Danish university hospital from 1997-2006. Staphylococcus species were the most common pathogens followed by streptococcus. Intravenous antibiotic therapy was started before surgery and continued for 4-6 weeks. The patients were followed-up for (1/2)-10 years (mean 5 years). RESULTS: 3 patients with prosthetic valve endocarditis died within the first 24 hours from heart failure. 2 of these patients required in addition implantation of mitral valve prostheses. 5 patients died 1-7 years after the operation from non-cardiac causes. Within the follow-up period no patients had relapse of endocarditis, and only one episode of recurrence endocarditis in an intravenous drug abuser was registered after 4 years. CONCLUSION: An aortic homograft in combination with intravenous antibiotics is an excellent treatment of severe endocarditis in the aortic valve or an aortic valve prosthesis.
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