This paper reports 15 native valve endocarditis cases had surgical operation in the past 10 years at the department of Cardiovascular and Thoracic Surgery, Chonbuk National University Hospital. In this study, 10 cases out of 15 were in class Ⅲ
or
Ⅳ by
the New York Heart Association functional classification. None of the cases had a history of taking addictive drugs.
Five cases were congenital heart disease, there cases were rheumatic heart disease and two cases were degenerative heart disease. Thus 10 cases had the underlying disease. All cases had antibiotics treatment for 3 to 6 weeks before operation. In
the
culture test, only four cases were positive in the blood culture and one case was positive in the excised valve culture. Organisms on blood and valve culture were Streptococcus epidermis, Streptococcus viridans, staphylococcus aureus and
Staphylococcus
epidermidis. In the 10 cases without ventricular septal defect, the aortic valve was involved in four, mitral in four, both in two and involved valves in the 5 cases with ventricular septal defect were tricuspid in three, pulmonic in two.
Eight cases had operation because they showed moderate congestive heart failure due to valvular insufficiency and vegetation with or without embolism. Seven cases had operation because they showed persistent or progressive congestive heart
failure
and/or uncontrolled infection. Five cases with ventricular septal defect underwent the closure of ventricular septal defect, vegetectomy and leaflet excision of the affected valves without valve replacement. In the cases without ventricular
septal
defect, the affected valves were replaced with St, Jude mechanical prosthesis.
Postoperative complications were recurrent endocarditis in two, embolism in one, allergic vasculitis in two, spleen rupture in one and postpericardiotomy syndrome in one. At the first postoperative day, one case died of cerebral embolism. At the
11th
postoperative month, one case died of recurrent endocarditis and paravalvular leakage in spite of a couple of aortic valve replacement. In the survived cases (13 cases in this study), all cases but one became class Ⅰ or Ⅱ by the New York Heart
Association functional classification.
(Korean J Thorac Cardiovasc Surg 1995;28:822-8)
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