XXXX . A survey.

@entity1 @entity340 @entity712 @entity295
Fifty eight @entity1 (aged 8-59 years, mean 27) treated for @entity340 from January 1966 to January 1985 were studied retrospectively by review of case notes. There were 12 cases of early and 46 cases of late @entity340 . These developed in 28 @entity1 with an isolated aortic valve, in 26 with an isolated mitral valve, and in four with both aortic and mitral prosthetic valves. Streptococci were the most commonly isolated microorganisms, followed by staphylococci, Gram negative bacteria, and fungi. A surgical (34 cases) or a necropsy specimen (10 cases) from 44 cases was examined. Eighty two per cent of the @entity1 had @entity712 . Twenty four of the 58 @entity1 were medically treated and 17 died (70% mortality). Combined medical and surgical treatment was used in 34 @entity1 ; the main indication for surgery was @entity712 . Fourteen @entity1 on combined treatment died (40% mortality). Persistent @entity295 and prosthetic valve dehiscence were the most common early and late operative complications. The most important influences on outcome were @entity712 , the type of micro-organism, the severity and extent of anatomical lesions, the time of onset of @entity340 , and the type of treatment. This survey indicates that only @entity1 without @entity712 and with sensitive micro-organism should be treated medically. In view of the poor prognosis @entity1 with @entity340 associated with @entity712 , persistent @entity295 , and repeat arterial emboli should be treated by early surgical intervention.
