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At least 433 records · Page 24Linked to original sources
PubMed1991

[The importance of the echocardiographic diagnosis of a mycotic aneurysm of the mitral septal leaflet in infectious endocarditis of the aortic valve: the surgical implications].

Mycotic aneurysm of the septal leaflet of the mitral valve is an infrequent complication associated with aortic infective endocarditis. The most probable mechanisms implicated on its formation are two: the lesion induced by regurgitant jet striking on septal mitral leaflet and the direct spreading of infection through the fibrosa inter-valvular. We describe the preoperative diagnosis of mycotic aneurysms of the septal mitral leaflet by two-dimensional echocardiography and color flow mapping in 2 patients. Surgical management will depend on the anatomic characteristics of the aneurysm and its hemodynamic repercussion. Careful echocardiographic search for mycotic mitral aneurysms should be performed in cases of aortic valve endocarditis, in view of its important prognostic implications.

Adult↗
PubMed1991

[Microbial spectrum and microbiological diagnosis of infectious endocarditis].

Still streptococci play the most important role as causatives of infective endocarditis. As change in composition of patient groups has taken place gradually pathogens like Staphylococcus epidermidis, enterococci, gram-negative rods and Candida species become more and more important now. Providing high-level accuracy if applied according to current rules blood culture is yet the basis for endocarditis caused by popular bacterial pathogens. If infection due to Candida species is suspected additional measuring of antibody response may be helpful in supporting the tentative diagnosis. Rare pathogens like Rickettsiae and Mycoplasma sp. must be considered for differential diagnosis, as infections caused by these organisms are to be identified by serological methods in first line.

Candidiasis↗
PubMed1991

[Therapy and prophylaxis of infectious endocarditis].

Infective endocarditis remains even today a potential lethal disease. The most frequent bacterial agents are viridans streptococci, staphylococci and enterococci. Left-sided endocarditis predominates except for patients with drug addiction. Modern recommendations of treatment are based on in vitro studies, experimental data from the animal model and clinical studies. Antimicrobial therapy should be parenteral and bactericidal in character. Detailed recommendations for treatment are given. Progressive heart failure, persistent bacteremia and repeated embolism are the most important reasons for surgical intervention. Modern prevention is performed as single or short-term prophylaxis for about sixteen hours. Simple practicability as well as handing out of guidelines to the patient will contribute to improved acceptance.

Endocarditis, Bacterial↗
PubMed1991

[Infectious endocarditis of the right heart. Apropos of 10 cases].

Ten cases of right-sided infective endocarditis (IE) were recorded in a retrospective study over a 5 year period (1984-88). In 8 cases, IE complicated known congenital heart disease. One patient was followed up for rhumatic valvular disease and in the remaining case, IE seemed to have occurred on a normal valve. The inclusion criteria were based on the clinical signs: prolonged pyrexia, the finding of a new murmur or a change on cardiac auscultation, and eventually, the occurrence of a complication (7 cases). The commonest complications were right ventricular failure and pulmonary embolism. A portal of entry was found in 5 cases: dental infection in 3 cases, osteomyelitis in 1 case and an abscess on the right leg in 1 case. Blood cultures were positive in 5 cases and grew a staphylococcus aureus on each occasion. Two-dimensional echocardiography showed vegetations in 9 cases. The short-term outcome was satisfactory. There were no fatalities and 5 patients underwent surgery.

Adolescent↗
PubMed1991

[An alternative approach in the surgical treatment of infectious endocarditis. The fresh antibiotic-sterilized aortic valve homograft].

Following the pioneering work of Ross and Barratt-Boyes, there is currently a strong evidence based on long-term follow-up data that valve homografts are the best valve substitutes in the aortic position. Currently there exists a renewed interest in the use of fresh and cryopreserved homografts as we know that homografts show a prolonged durability together with the lack of thromboembolic complications. Here we present the case histories of 3 patients undergoing aortic valve replacement by fresh homografts sterilized in antibiotic solution. The underlying pathology was infective endocarditis in all 3 patients, a disease that is considered the ideal indication for homograft implantation. Technical details at the time of implantation, their advantages with regard to other replacements devices and the whole process of procurement, manipulation and preservation are commented on.

Adult↗
PubMed1990

[Neonatal infectious endocarditis. Apropos of 5 cases].

Five cases of neonatal infective endocarditis are reported. The mitral, tricuspid and pulmonary valves were involved either alone or in association. The predisposing factors were multiple: umbilical catheter, respiratory distress with assisted ventilation, septicemia, osteoarthritis or gastroenteritis. Only one child had a minor cardiac malformation. The causal organism was a staphylococcus aureus in all cases. All children had disseminated intravascular coagulation and a cardiac murmur. The diagnosis was confirmed by echocardiographic demonstration of bacterial vegetations. Three of the 5 children died despite long-term antibiotic therapy. In one case, a vegetation embolised to the pulmonary artery. In the two cured neonates the vegetations disappeared. These cases illustrate the value of echocardiography which should be performed in all neonates with septicemia or disseminated intravascular coagulation, especially when there is an associated cardiac murmur.

Disseminated Intravascular Coagulation↗
PubMed1990

[Study of infectious endocarditis using Doppler echocardiography].

Infective endocarditis is still a common and serious disease. Echocardiography is an essential complementary investigation in this condition. Its value in the diagnosis of valvular vegetations has become more accurate since the introduction of two-dimensional and transesophageal echocardiography. Transesophageal echocardiography is currently the most reliable non-invasive technique for demonstrating small vegetations of less than 5 mm diameter. The diagnosis and surveillance of complications (valvular destruction, ring abscess) are also privileged indications of transthoracic and transesophageal echocardiography coupled with intracardiac Doppler blood flow studies. The finding of these lesions may sometimes lead to early surgical management.

Echocardiography, Doppler↗
PubMed1990

[Infectious endocarditis of the tricuspid valve in patients with endocardial pacemakers].

Right heart endocarditis in patients with permanent cardiac pacing catheters is uncommon but not an exceptionally rare complication. Two dimensional echocardiography provides diagnostic and prognostic information. The authors report two cases which illustrate the fact that many workers recommend explanation of the pacing catheter and that tricuspidectomy with or without valve replacement may sometimes be necessary.

Adult↗