AATS Endocarditis 2017

Question 1

who should get surgical treatment for Endocarditis

Answer 1

1. signs of heart failure
2. severe valve dysfunction
3. Invasion of paravalvular abscess or cardiac fistula
4. recurrent systemic embolization
5. large mobile vegetations.
6. systemic sepsis despite 5-7 days of ab therapy

Question 2

what % of patients that have endocarditis have complications that will require an operation?

Answer 2

50%

Question 3

Most common preventable complication of IE

• what does that mean for the threshold to operate?

Answer 3

The most common preventable complication is embolization

that means that there is a lower threshold to operate with mobile vegetation

Question 4

Surgery for Q-fever endocarditis

Answer 4

generally indicated for hemodynamic reasons.

If possible, at least three weeks of antimicrobial treatment should be given prior to valve replacement.

Question 5

Mortality Rate for infective endocarditis

Answer 5

in-hospital: 15% to 20%

1-year: 40%.

Question 6

What Organisms that are typical of Endocarditis should raise suspicion.

Answer 6

• Viridans streptococci
• Streptococcus bovis
• HACEK group (Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella spp, and Kingella kingae),
• S. aureus;
• community-acquired enterococci

in the absence of a primary focus

Question 7

Frequency of endocarditis amoung patients with Staph Aureus Bacteremia

Answer 7

30%

therefore TEE is reasonable