活動期感染性心内膜炎に対する抗菌薬投与を先行させた外科的治療成績

Surgical Outcomes Prior to Antibiotics Administration for Infective Endocarditis

感染性心内膜炎（IE）と診断された場合の在院死亡は15～30％と依然高いことが広く知られている1～6）が，現在も外科的治療の介入時期についてはガイドラインに照らしても議論の余地がある7～9）．

Object：We examined the surgical outcomes for infective endocarditis （IE） at our institution.

Methods：Between January 2012 and March 2022, we operated on 43 patients who diagnosed active IE. We decided to perform surgery after antibiotics administration for at least two weeks.

Results：The mean age was 63.9 years old, and 28 male were included. The affected valves were 12 aortic valves, and 26 mitral valved and five multi valves, the causative microorganisms were Staphylococcus aureus 14 patient, Staphylococcus spp. 3 patients, Streptococcus spp. 17 patients, Enterococcus spp. 3 patients, and others 6 patients. One patient underwent aortic valve repair, and 17 patients underwent aortic valve preplacement. Twenty four underwent mitral valve repair, and eight underwent mitral valve replacement. The duration of preoperative antibiotics administration was 27.7±2.1 days （median 28 days）. There were six in-hospital death （motality 14.0％）. The five-years survival rate was 78.1％ and the freedom from cardiac events at five years was 88.4％．

Conclusion：The strategy for preoperative management and timing of surgery for IE patients at our institution was appropriate.