SURGICAL ASPECTS OF ENDOCARDITIS OF AORTIC ROOT

Eleven patients were operated upon for severe aortic insufficiency secondary to bacterial endocarditis. In 6 patients, satisfactory medical treatment was accomplished well before surgery. In 5, intractable congestive failure and a critical clinical situation necessitated surgery while medical treatment was in progress. There were 10 survivors (91 per cent) and 1 death (9 per cent) in this group of patients followed up from three months to four years. The organisms responsible, their routes of entry and pre- and postoperative antibiotic regimens are presented. All patients exhibited one or more leaflet tears or perforations. In the acutely ill group, two aortic ring abscesses and one high ventricular septal defect were encountered. A ball valve prosthesis was used for aortic valve replacement in every instance. Teflon felt grafts were employed to replace the aortic perforations in the patients with abscess formation and to close the ventricular septal defect. The surgical results are most encouraging since death was considered imminent in 5 patients and inevitable in all patients without operative intervention. © 1969.