Surgical outcomes in native XXXX : the experience of the Cardiovascular Surgery Department - Cluj-Napoca Heart Institute.

@entity1 @entity5645 @entity339 @entity281 @entity340 @entity166
BACKGROUND AND AIMS: The introduction of Duke's criteria and the improvement of imaging methods has lead to an earlier and a more accurate diagnosis of @entity166 ( @entity166 ). The options for the best therapeutic approach and the timing of surgery are still a matter of debate and require a close colaboration between the cardiologist, the infectionist and the cardiac surgeon. METHODS: We undertook a retrospective, descriptive study, spanning over a period of five years (from January 1st, 2007 to December 31st, 2012), on 100 @entity1 who underwent surgery for native @entity340 in our unit. RESULTS: The @entity1 ' age varied between 13 and 77 years (with a mean of 54 years), of which 85 were males (85%). The main microorganisms responsible for @entity166 were: Streptococcus @entity5645 . (21 cases - 21%), Staphylococcus @entity5645 . (15 cases - 15%), and Enterococcus @entity5645 . (9 cases - 9%). The potential source of @entity281 was identified in 26 @entity1 (26%), with most cases being in the dental area (16 cases - 16%). The lesions caused by @entity166 were situated in the left heart in 96 @entity1 (96%), mostly on the aortic valve (50 cases - 50%). In most cases (82%) we found preexisting endocardial lesions which predisposed to the development of @entity166 , most of them being @entity340 (38 cases - 38%). We performed the following surgical procedures: surgery on a single valve - aortic valve replacement (40 cases), mitral valve replacement (19 cases), @entity339 (1 case), surgery on more than one valve - mitral and aortic valve replacement (20 cases), aortic and tricuspid valve replacement (1 case), aortic valve replacement with a mechanical valve associated with @entity339 (5 cases), aortic valve replacement with a biological valve associated with @entity339 (2 cases), and mitral valve replacement with a mechanical valve combined with De Vega procedure on the tricuspid valve (1 case). In 5 @entity1 (5%) the bacteriological examination of valve pieces excised during surgery was positive. In 3 cases it matched the germ identified in the hemocultures, and in 2 cases it evidenced another bacterium. CONCLUSION: The overall mortality of 5% is well between the limits presented in literature, being higher (30%) in @entity1 who required emergency surgery. For the @entity1 who return into our clinic with @entity340 , the mortality after surgery was even higher (50%).
