SURGICAL MANAGEMENT AND EARLY OUTCOMES OF INFECTIVE ENDOCARDITIS: A DESCRIPTIVE STUDY AT A TERTIARY CARE HOSPITAL

Abstract

Objective: To determine the factors associated with the early postoperative outcomes of patients with valvular infective endocarditis at a tertiary care hospital.

Study Design: Descriptive cross sectional study.

Place and Duration of Study: Armed forces Institute of Cardiology and National Institute of Heart Disease (AFIC/NIHD) Rawalpindi from 2013-2015

Material and Methods: We retrospectively reviewed all the data from our infective endocarditis registry at AFIC&NIHD from January 2013 to December 2015. During this period 41 patients underwent surgical treatment of infective endocarditis. Patients were only included in the study according to the Modified Duke’s Criteria. Data collection was done through structured performa consisting of demographics, pre, per and post operative characteristics of the patients.

Results: A total number of 41 patients were included in this study with males 22(53.7 %) and females 19(46.3%) respectively. The mean age of our study population was 37 ± 13.3 years whereas majority 23(56.1%) of the patients were young <36 years of age. Maximum number of procedures performed were mitral valve replacements 13 (31.7%) among all the surgical procedures conducted. The mean bypass time and aortic clamp times noted were 149 ± 81.0 and 98± 52.5 minutes respectively and almost all the operation used mechanical valves 40(97.6%) as valve replacements. Reexploration was done for tamponade 3(7.3%) and bleeding (3(7.3%). Wound sepsis was minimal 1(2.4%). The overall mortality of our study population was 12.2% (5 patients).

Conclusion: In our local population, the incidence of infective endocarditis is in young adults. The clinical presentation, site of valvular infection, and the type of pathological microorganisms were typical of infective endocarditis reported from our region.