VALVE-REPLACEMENT IN PATIENTS WITH ENDOCARDITIS AND CEREBRAL SEPTIC EMBOLI

被引:60
|
作者
TING, W
SILVERMAN, N
LEVITSKY, S
机构
[1] UNIV ILLINOIS,DEPT SURG,CHICAGO,IL 60680
[2] UNIV MED & DENT NEW JERSEY,DEPT SURG,NEW BRUNSWICK,NJ 08903
来源
ANNALS OF THORACIC SURGERY | 1991年 / 51卷 / 01期
关键词
D O I
10.1016/0003-4975(91)90439-W
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cerebral septic emboli complicate the cases in 20% to 40% of patients with left-sided endocarditis but the management of these patients who require a valvar operation remains unclear. From 1980 to 1988, the incidence of cerebral septic embolus was 42% (n = 45) among 106 patients with endocarditis who underwent valve replacement at the University of Illinois Hospital in Chicago. Of these 45 patients, 69% (n = 31) had symptomatic cerebral septic infarctions, and 31% (n = 14) were asymptomatic. Findings on cerebral computed tomographic scans included ischemic infarcts (n = 36, 80%), hemorrhagic infarcts (n = 5, 11%), normal studies (n = 2, 4%), and unknown (n = 2, 4%). Neurological complications after valve replacement included postoperative strokes (n = 6, 6%), cerebral abscesses (n = 2, 2%), and seizure (n = 1, 1%). The presence of a hemorrhagic infarct preoperatively predisposed to a perioperative stroke (p < 0.05). In conclusion, cerebral septic infarctions, both symptomatic and asymptomatic, are common among patients with endocarditis referred for valvar operation. In the absence of a hemorrhagic infarct, valve replacement can be performed with minimal risk of a perioperative stroke.
引用
收藏
页码:18 / 22
页数:5
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