Titre
Chirurgie der Endokarditis beim Drogensuchtigen und HIV-Patient. Ein prospektiver Vergleich mit der konservativen Behandlung. [Surgery of endocarditis in the drug dependent and HIV patient. A prospective comparison with conservative treatment]
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Helvetica Chirurgica Acta
Auteur(s)
Carrel, T.
Auteure/Auteur
Schaffner, A.
Auteure/Auteur
Pasic, M.
Auteure/Auteur
Ritter, M.
Auteure/Auteur
Oechslin, E.
Auteure/Auteur
Laske, A.
Auteure/Auteur
Niederhauser, U.
Auteure/Auteur
Schonbeck, M.
Auteure/Auteur
von Segesser, L. K.
Auteure/Auteur
Turina, M.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0018-0181
Statut éditorial
Publié
Date de publication
1993-12
Volume
60
Numéro
3
Première page
439
Dernière page/numéro d’article
45
Notes
Comparative Study
English Abstract
Journal Article --- Old month value: Dec
English Abstract
Journal Article --- Old month value: Dec
Résumé
The incidence of infective endocarditis in drug addicts is increasing with the spreading of intravenous drug abuse. The tricuspid valve is the most commonly involved valve followed by the mitral valve. We evaluated prospectively 22 patients with a mean age of 23 years, presenting with addiction-associated endocarditis endocarditis and referred to our institution during a three-year period. The tricuspid valve was involved in 13 instances, mitral valve in 4, mitral plus tricuspid valve in 5 patients and aortic valve in 1 case. Staphylococcus aureus was the most frequent infective organism (15x), followed by Streptococci (4x), Corynebacteria (2x) and one case with a mixed infection. Six patients were positive for an HIV-infection and 17 had evidence for a chronic viral hepatitis. Ten patients (3 of them HIV-seropositive) were treated surgically. Resection of the tricuspid valve with (1x) or without replacement (4x), resection of vegetations and valve repair (2x), mitral valve replacement (2x), aortic valve replacement (1x) were performed. In case of tricuspid endocarditis, the decision whether to proceed with resection, repair or replacement with a bioprosthesis was taken according to valve pathology and the psycho-social situation of the patient. When the vegetations involved only one leaflet and could be removed easily, vegetectomy with annuloplasty or with repair using autologous pericardium was performed. Valvulectomy without replacement was the chosen method for those where persistent or recurrent drug abuse could not be excluded. A bioprosthesis was inserted when the tricuspid valve was completely destroyed and there was a proven abstinence from drugs over a period of several weeks preoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
Sujets
PID Serval
serval:BIB_ABC87D06CE0A
PMID
Date de création
2008-02-14T13:18:21.062Z
Date de création dans IRIS
2025-05-20T21:12:44Z