Circulation, Vol 59, 327-335, Copyright © 1979 by American Heart Association
EL Kaplan, H Rich, W Gersony and J Manning
Twenty-six major cardiovascular centers participated in a cooperative study
of all cases of infective endocarditis occurring during a single calendar
year to obtain an overview of infective endocarditis. The study was
designed to learn which patients appear to be at highest risk to develop
this infection after palliative or reparative cardiovascular surgery. Of
278 patients developing infective endocarditis during the year at these
medical centers, 63 (23%) had had previous cardiovascular surgery and 215
had not. Seventy percent of the 278 patients had recognized congenital or
acquired heart disease before developing the infection. Rheumatic heart
disease accounted for over half of the patients with underlying structural
heart disease. A majority (55%) of the 63 patients who had been operated on
before developing endocarditis had prosthetic valves inserted. Of those who
did not require prosthetic valves, the majority had congenital heart
disease with systemic artery- to-pulmonary artery shunts. Although these
data were obtained from a selected group of patients, they confirm a
significant risk of endocarditis in patients with prosthetic valves and
suggest that in postoperative patients with non-valvular congenital heart
disease, the highest risk appears to be in cyanotic patients with
palliative pulmonary artery-to-systemic artery shunts.
ARTICLES
A collaborative study of infective endocarditis in the 1970s. Emphasis on infections in patients who have undergone cardiovascular surgery
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