Surgical Management of Patients with Aortic Root Abscess: An Interventional Study | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 291, Volume 89, Issue 1, October 2022, Pages 5984-5990 PDF (549.81 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2022.266829 | ||
| Authors | ||
| Ahmed H. Lamlom; Wageih Saad Elboraey; Alaa Eldin Farouk; Hossam Fathy Aly* | ||
| Department of Cardio Thoracic Surgery, Faculty of Medicine, Cairo University, Egypt | ||
| Abstract | ||
| Background: It is still challenging for cardiovascular surgeons to treat aortic root abscess, a severe type of infective endocarditis (IE) of the aortic valve and the surrounding tissues. Objectives: We aimed to assess the proper timing for surgical intervention, the rate of hospital mortality and recurrence, and mid-term survival in patients with active IE of the aortic valve. Patients and Methods: Thirty patients with aortic root abscesses were subjected to isolated aortic root surgery between March 2016 and September 2017 at the Department of Cardio-thoracic Surgery at Kasr El-Ainy hospital, Cairo University, Egypt. Results: Out of the 30 patients, 19 were females (63.33%), and 11 were males (36.67%), with a mean age of 39.5 ± 15.5 years. The mean diameter of the abscess cavities was 1.85 ± 0.82 cm, most commonly located in the non-coronary sinus (63.33%). The common causative microorganisms were Staphylococcus spp < /em>. (36.67%), followed by Streptococcus spp < /em>. (23.33%), Pseudomonas aeruginosa (16.67%), and Candida sake (6.67%). The mortality rate was 23.33% and 16.67% were early, and 6.67% were late. Patients with prosthetic valve endocarditis (PVE) were associated with larger vegetation size, the abundance of Staphylococcus infection, a higher proportion of AV dehiscence, longer operative, aortic cross-clamp and bypass times, and longer ICU stay. The overall recurrence rate was 16.67%. Conclusion: Early outcomes of AIE of the aortic valve could be enhanced through proper diagnosis, earlier referral to surgery, radical excision of infected tissue, at least a one-month course of intravenous antibiotics according to the culture and sensitivity, or broad-spectrum empirical agents in culture-negative cases. | ||
| Keywords | ||
| Infective endocarditis; Prosthetic valve endocarditis; Aortic root abscess; Native valve endocarditis | ||
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