Indication of surgery in infective endocarditis скачать в хорошем качестве

Indication of surgery in infective endocarditis

1. PR prolongation in ECG suggests paravalvular extension of the infection (paravalvular abscess/ myocardial abscess) 2. Infection due to difficult to treat pathogen such as fungal or other highly resistant organisms (e.g. VRE, Brucella endocarditis or MDR gram negative bacilli) 3.persistent infection (manifested as persistent bacteremia or fever lasting greater than 10 days and provided other sites of infection and causes of fever have been excluded) after start of appropriate antibiotic therapy 4. persistent unexplained fever (greater than 10 days) in culture negative valve endocarditis) 5.patients presenting with recurrent emboli and persistent or enlarging vegetation despite appropriate antibiotic therapy 6. patient with severe valve regurgitation and mobile vegetation greater than 10 mm 7. presence of mobile vegetation greater than 10mm, particularly when involving the anterior mitral leaflet and associated with other relative indications of surgery a). partially dehisced unstable prostheric valve b). staph aureus prosthetic valve endocarditis with an intracardiac complication (e.g. paravalvular / myocardial abscess) c). relapse of prosthetic valve endocarditis after optimal antimicrobial therapy d). poorly responsive staph aureus endocarditis involving aortic or mitral valve