Some features of surgical treatment of paravalvular abscesses in patients with primary/secondary infective endocarditis

The research data obtained while carrying out surgical treatment of 58 patients with infective endocarditis-related paravalvular abscesses over a period of 1988-2007 were analyzed. The patients' age varied from 18 to 67. Primary infective endocarditis was observed in 38 patients (65.5%), secondary one - in 20 patients (34.5%). All the patients fell under NYHA IV functional class. Various types of paravalvular abscesses and mycotic aneurysms were revealed. Complex reconstructive surgeries on the above patients followed by complications were analyzed. The postoperative follow-up resulted in 3 deaths (5.1%). In the long-term period 3 patients underwent re-replacement of the aortic valve because of a paravalvular fistula and the mitral valve of 1 patient was re-replaced due to endocarditis of the prosthesis. 51 patients (92.7%) were followed up in the long-term period. 3 patients died as a result of various complications. According to our data paravalvular processes are being developed over a long period of treatment, therefore surgical indications in infective endocarditis patients have to be determined at earlier stages of the disease