Abstract:

Objective To summarize the experience in perioperative management of right-sided infective endocarditis. Methods The clinical data of 16 patients undergoing surgical treatment for right-sided heart infective endocarditis were retrospectively analysed. Blood culture and drug susceptibility tests were performed, and intracardiac vegetations were revealed by transthoracic echocardiography in all patients before surgery. Foci of infection and vegetations were removed by surgery under cardiopulmonary bypass, congenital heart diseases were corrected, damaged valves were reconstructed or replaced, and bacterial culture and drug susceptibility tests of resected vegetations were performed. Results A total of 30 times of blood culture were conducted, and the positive rate was 26.7%. There were positive findings in 4 patients in blood culture. In patients with negative results in blood culture, 5 patients had positive findings in bacterial culture of vegetations. The pathogens were Gram-positive Staphylococci in 6 patients, which were resistant to penicillin. Two patients had emergency surgery. Pleural effusion occurred in 5 patients after surgery, and 1 patient were performed cardiopulmonary resuscitation due to ventricular fibrillation. All patients were cured and discharged. Conclusion Most patients with right-sided infective endocarditis are complicated with basic heart diseases, the main pathogen is Grampositive Staphylococci, transthoracic echocardiography can help to confirm the diagnosis, and surgical treatment may yield favorable outcomes.

Key words: endocarditis, antibiotic therapy, surgical procedure