HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cowgill, L. D. Articles by Harken, A. H. Search for Related Content PubMed PubMed Citation Articles by Cowgill, L. D. Articles by Harken, A. H.

The Annals of Thoracic Surgery, Vol 43, 450-457, Copyright © 1987 by The Society of Thoracic Surgeons

ARTICLES

A practical approach to prosthetic valve endocarditis

LD Cowgill, VP Addonizio, AR Hopeman and AH Harken

Prosthetic valve endocarditis (PVE) is an infrequent but dread complication, occurring in 1 to 2% of patients both early (less than 60 days) and late postoperatively. Diagnosis is always (99%) possible by two sets of blood cultures, but occasional exogenous causes of bacteremia may cloud the diagnosis, as will culture-negative cases of PVE and skin contaminants. With obvious exogenous sources of bacteremia, achieving sterile blood cultures after eradication of the noncardiac source permits discontinuation of antibiotics after two weeks. When skin contaminants are suspected, withholding antibiotics and obtaining two sets of blood cultures is recommended, because the bacteremia with PVE is continuous. Preventive measures, including perioperative antibiotics, are warranted but will probably not significantly reduce the low incidence of infection already achieved. The major cause of improved survival in recent years is earlier operation (valve rereplacement). This has been demonstrated in the last ten years and is absolutely indicated for major heart failure, ongoing sepsis, fungous etiology, valve obstruction, new-onset heart block, and unstable prosthesis by fluoroscopy.

This article has been cited by other articles:

				2006 WRITING COMMITTEE MEMBERS, R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, October 7, 2008; 118(15): e523 - e661. [Full Text] [PDF]

				R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., September 23, 2008; 52(13): e1 - e142. [Full Text] [PDF]

				S. C. Stamou, G. Petterson, and A. M. Gillinov Surgical Treatment of Mitral Valve Endocarditis Card. Surg. Adult, January 1, 2008; 3(2008): 1069 - 1078. [Full Text]

				R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): e1 - e148. [Full Text] [PDF]

				P. A. Fedalen, C. A. Fisher, B. A. Todd, P. J. Mather, and V. P. Addonizio Early fungal endocarditis in homograft recipients Ann. Thorac. Surg., October 1, 1999; 68(4): 1410 - 1411. [Abstract] [Full Text] [PDF]

				P. E. Parrino, I. L. Kron, S. D. Ross, K. S. Shockey, A. M. Kron, M. A. Towler, and C. G. Tribble Does a focal neurologic deficit contraindicate operation in a patient with endocarditis? Ann. Thorac. Surg., January 1, 1999; 67(1): 59 - 64. [Abstract] [Full Text] [PDF]

				F. L. Grover, D. J. Cohen, C. Oprian, W. G. Henderson, G. Sethi, K. E. Hammermeister, and Participants in the Department of Veterans Affairs Determinants of the occurrence of and survival from prosthetic valve endocarditisExperience of the Veterans Affairs Cooperative Study on Valvular Heart Disease J. Thorac. Cardiovasc. Surg., August 1, 1994; 108(2): 207 - 214. [Abstract] [Full Text]

				J. T. Harrington and R. B. Colvin Case 12-1994- A 72-Year-Old Man with Chronic Leg Ulceration and Progressive Renal Failure N. Engl. J. Med., March 24, 1994; 330(12): 847 - 854. [Full Text]