From April, 1981, through March, 1989, 30 patients had received valve replacements and 1 patient had received foreign body removal for infective endocarditis at Seoul National University Hospital. There were 22 male and 9 female patients, ranged in age from 22 to 59 (mean 34.9) years.
Twenty-three had native valve endocarditis, 7 had prosthetic valve endocarditis and 1 had infected transvenous permanent pacemaker electrode in right heart. Twenty-four required operation during active phase of disease and 7 during inactive phase.
The infecting organism was Streptococcus in 10 patients, Staphylococcus in 5 patiel:.ts, both Staphylococcus and Streptococcus in 1 patient, E. coli in 2 patients, and Candida in 1 patient.
Indications for Surgery were congestive heart failure in 20, systemic emboli in 5, combination of both in 3, congestive heart failure with uncontrolled sepsis in 2, and complete heart block in 1 patient.
Hospital mortality was 9.7 % (3/31), and all were the patients who received emergency operation. There were 2 late mortality (7.7 %) due to acute myocardial infarction and recurrent endocarditis.
This report suggests that the surgical treatment can be achieved with acceptable low mortality and morbidity in medically intractable congestive heart failure, emboli and sepsis.
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