Endocarditis surgical indications: Difference between revisions
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# Perivalvular extension of infection and abscess formation | # Perivalvular extension of infection and abscess formation | ||
# [[Staphylococcal]] infection of prosthesis | # [[Staphylococcal]] infection of prosthesis | ||
# Persistent fever (culture negative) | # Persistent [[fever]] (culture negative) | ||
# Large vegetation (>10 mm is associated with an increased risk of embolism) | # Large vegetation (>10 mm is associated with an increased risk of embolism) | ||
# Relapse after optimal therapy in a native valve | # Relapse after optimal therapy in a native valve | ||
# Vegetations that obstruct the valve orifice | # Vegetations that obstruct the valve orifice | ||
#Onset of [[AV block]] | |||
==References== | ==References== |
Revision as of 22:02, 8 October 2012
Endocarditis Microchapters |
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2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Indications for surgical debridement of vegetations and infected perivalvular tissue, with valve replacement or repair as needed are listed below:[1]
- Moderate to severe congestive heart failure due to valve dysfunction
- Unstable valve prosthesis
- Uncontrolled infection for > 1–3 week despite maximal antimicrobial therapy
- Persistent bacteremia
- Fungal endocarditis
- Relapse after optimal therapy in a prosthetic valve
- Vegetation in Situ
- Prosthetic valve endocarditis with perivalvular invasion
- Endocarditis caused by Pseudomonas aeruginosa or other gram-negative bacilli that has not responded after 7–10 days of maximal antimicrobial therapy
- Perivalvular extension of infection and abscess formation
- Staphylococcal infection of prosthesis
- Persistent fever (culture negative)
- Large vegetation (>10 mm is associated with an increased risk of embolism)
- Relapse after optimal therapy in a native valve
- Vegetations that obstruct the valve orifice
- Onset of AV block
References
- ↑ Baddour Larry M., Wilson Walter R., Bayer Arnold S., Fowler Vance G. Jr, Bolger Ann F., Levison Matthew E., Ferrieri Patricia, Gerber Michael A., Tani Lloyd Y., Gewitz Michael H., Tong David C., Steckelberg James M., Baltimore Robert S., Shulman Stanford T., Burns Jane C., Falace Donald A., Newburger Jane W., Pallasch Thomas J., Takahashi Masato, Taubert Kathryn A. (2005). "Infective Endocarditis: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association-Executive Summary: Endorsed by the Infectious Diseases Society of America". Circulation. 111 (23): 3167–84. PMID 15956145.