Pathology:
Patients with congenital structural abnormalities of the heart such as Mitral Valve Prolapse, Biscuspid Aortic Valve, Ventricular Septal Defect (VSD) and PDA are susceptible to develop secondary infections to the heart valves.
Alternatively, certain surgical procedures, such as Dental Extraction, Prostrate Surgery and in cases of Intravenous Drug Abuse, there is a risk of Heart Valves acquiring secondary infections through blood stream. Such infections are commonly referred to as Infective Endocarditis.
Complications:
This infection presents itself as an intermittent fever which does not subside even after routine course of antibiotics. It may also present with sudden breathlessness with heart failure and embolism.
Treatment:
The usual investigations needed to diagnose and plan treatment for Infective Endocarditis are ECG, Echocardiography (2D Echo) and occasionally, Transesophageal Echocardiography (TEE) or Cardiac MRI. In patients above 40 years of age, Coronary Angiography is required to identify Coronary Artery Blockages.
The corrective surgical procedures for Infective Endocaritis is Open Heart Surgery. The chest bone (Sternum) is split vertically to access the heart.
Depending on the valve involvement, alongwith excision of the infected heart tissue, the patient might require any of the following procedure:
- Mitral Valve Replacement
- Aortic Valve Replacement
- Double Valve Replacement
- Mitral Valve Repair
- Tricuspid Valve Repair/Replacement
Depending on the age of the patient, Mechanical or Bioprosthetic Valve may be chosen. As the infection occasionally damages the nerves (Conduction Tissues) of the heart, a pacemaker may have to be implanted post-operatively to maintain heart rate and rhythm.
Salient Features of Infective Endocarditis Surgery
- Irrespective of the type of Prosthetic Valves used, the patient is able to return to an active and healthy life after Infective Endocarditis Surgery.
- The patients display significant symptomatic improvement after Infective Endocarditis Surgery.
- In some cases, where Coronary Artery blockages are observed along with Infective Endocarditis, both Coronary Artery Bypass Grafting (CABG) & Valve Replacement Surgeries for Infective Endocarditis can be performed simultaneously.
