Infective endocarditis in cardiosurgical patients: diagnostics, prognostication and prevention issues

Clinical, microbiological features and the nature of morphological changes of valve structures in patients with infective endocarditis of native valves (IENV) and those with infective endocarditis of prosthetic valves (IEPV) needing surgery have been studied. Analyzed are the time and indications for surgical treatment, the nature of postoperative complications and causes of hospital lethality. A mathematical model to prognosticate an initial form of IEPV has been worked out, which provides assistance in timely diagnostics of a given complication. An important role of exogenous infection in development of IEPV is shown. A new regimen of intra- and post-operative antimicrobe prevention measures in patients who underwent prosthetic valve repair is offered. The regimen incorporates an antifungal drug and an antibiotic with high antistaphylococcus activity and allows for reducing the occurrence of IEPV by 2.07 times.