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Infective endocarditis with cerebrovascular complications: timing of surgical intervention.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Fukuda, Wakako Daitoku, Kazuyuki Minakawa, Masahito Fukui, Kozo Suzuki, Yasuyuki Fukuda, Ikuo
Description	Country affiliation: Japan Author Affiliation: Fukuda W ( Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.)
Abstract	Management of infective endocarditis (IE) with cerebrovascular complications is difficult due to absence of concrete evidence. These patients usually have multiple neurological deficits and the optimal timing for cardiac operation remains controversial. The aims of this study were to present cases and discuss the treatment options for IE with cerebrovascular complications. From 1998 to 2010, 51 patients underwent operations for IE at our institution. From a review of medical records, 10 patients (19.6%) with preoperative neurological complications were identified. Data on these 10 patients were analysed. Cerebrovascular complications included cerebral infarction (n = 4, 40.0%), mycotic aneurysm (n = 1, 10.0%), mycotic aneurysm plus cerebral infarction (n = 3, 30.0%), meningitis (n = 1, 10.0%) and mycotic aneurysm with cerebral haemorrhage plus meningitis (n = 1, 10.0%). Of 5 patients having mycotic aneurysms, 3 underwent clipping before cardiac operations. The mean interval from craniotomy to cardiac operations was 26.7 ± 21.8 days. A cardiac operation was performed initially on seven patients. The mean interval from the onset of neurological deficit to cardiac operation was 7.4 ± 9.8 days. The mortality rate was 10.0%. Postoperative deterioration was not observed. Management of IE with cerebrovascular complications should be based on case-by-case multidisciplinary assessment of potential risks and benefits of intracranial and cardiac operations.
File Format	HTM / HTML
ISSN	15699293
e-ISSN	15699285
DOI	10.1093/icvts/ivr038
Journal	Interactive CardioVascular and Thoracic Surgery
Issue Number	1
Volume Number	14
Language	English
Publisher	Oxford University Press
Publisher Date	2012-01-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Cardiology Discipline Surgery Cardiac Surgical Procedures Adverse Effects Cerebrovascular Disorders Etiology Endocarditis Adolescent Diagnosis Child, Preschool Infant Postoperative Complications Time Factors Tomography, X-ray Computed
Content Type	Text
Resource Type	Case study Article
Subject	Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine

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Infective endocarditis with cerebrovascular complications: timing of surgical intervention

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