EARLY ONSET PROSTHETIC VALVE ENDOCARDITIS

Abstract

Although early prosthetic valve endocarditis is a rare complication occurring during the early post operative period, but it can be considered the most serious one as early infection is usually severe and invasive and most probably leads to further complications and sometimes ends in patient's death.

Diagnosis of early prosthetic valve endocarditis is rather a difficult mission as its clinical presentations may be deceiving and its signs and symptoms always simulated by many other medical problems, so definite diagnosis always not established at the optimum time. Treatment of early prosthetic valve endocarditis is another major problem as the severity of infection in these cases may always lead to both intracardiac complications such as prosthetic valve dehisence and dysfunction and extension oi intracardiac infection beyond the valve, and also extracardiac complications such as systemic emboli that may affect any of the body systems or organs. For all of the above, it is mandatory when dealing with early prosthetic valve endocarditis to apply the golden rule: " Protection is better than treatment " We have to study carefully the possible risk factors that may predispose to occurrence of early prosthetic valve endocarditis and take all precautions in order to avoid these risk factors aiming to reduce the incidence of occurrence of early prosthetic valve endocarditis as much as possible. All of the above were the great stimulus for us to make this study to clarify and explain some points about early prosthetic valve endocarditis in our cardiac surgery center in order to improve our work and decrease morbidity and mortality of open hemi surgery patients as much as possible. The aim of this work is to detect the incidence of early onset prosthetic valve endocarditis in Open Heart Surgery Unit- Tanta University Hospitals and to examine the possible risk factors that may increase the rate of infection. We have studied 260 patients undergoing heart valves replacement or repair using prostheses in Open Heati Surgery Unit- Tanta University Hospital during the period from 1-1- 1998 to 31-12-2003.