人工弁感染性心内膜炎の外科治療経験

Surgical Outcomes of Prosthetic Valve Endocarditis

感染性心内膜炎（IE）は適切な治療を受けない限り致命的な疾患である．IEの院内死亡率は15～20％で，1年死亡率は40％近い1）．特に弁置換術後の主要な合併症である人工弁IE（PVE）は，人工弁置換術患者1人あたり年間0.3～1％の割合で発生し，IEの全例の16～34％を占める2，3）．10年生存率は約60％であり，遠隔期死亡率は16％，再手術率は20％と報告されている3）．

Prosthetic valve endocarditis is a fatal complication after valve replacement surgery. Early surgical intervention is recommended for patients who suffer from complications such as heart failure, valve dysfunction, and abscesses. In the present study, we evaluated the clinical characteristics of 18 patients who underwent surgery for prosthetic valve endocarditis at our institution between December 1990 and August 2022, and examined the appropriateness of the timing and method of surgery, and whether there was improvement in cardiac function. Guidelines-based surgical intervention resulted in improved survival and improved cardiac function in the early and late postoperative period.