Abstract
Indications for surgery were (i) severe congestive heart failure (NYHA class III) in 21 patients (32%) and cardiogenic shock in nine of them (14%), (ii) septic emboli in 22 patients (35%) including 10 cases (16%) of stroke with no intracranial bleeding, 5 cases (8%) of TIAs and3 cases (4.7%) ofcerebral abscesses and(iii) persistent sepsis in11 patients (17%). Preoperative transoesophageal echocardiography revealed vegetations in 51 patients (81%), mitral regurgitation (MR) grade 3 in 40 patients (63.5%) and intracardiac abscesses or fistulas in 17 patients (27%). Forty-two patients (67%) had isolated mitral valve endocarditis, 20 (32%) had both mitral and aortic valve endocarditis and one had mitral and tricuspid valve endocarditis. Immediate postoperative transoesophageal echocardiography indicated no residual MR in 48 patients (76.2%) and MR grade 1 in13 patients (21.6%). Inonly two patients (3.2%), a residual MRof grade2 was acceptedbecause of advanced age. NoMV stenosis was observed at this time.
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