PMID- 23558229
OWN - NLM
STAT- MEDLINE
DCOM- 20150219
LR  - 20190608
IS  - 2186-1005 (Electronic)
IS  - 1341-1098 (Linking)
VI  - 20
IP  - 3
DP  - 2014
TI  - Management of infective endocarditis with cerebral complications.
PG  - 229-36
AB  - PURPOSE: Management of patients with infective endocarditis complicated by 
      neurological deficits is challenging. No clear management guidelines have been 
      defined, and the timing of surgery remains controversial. The purpose of this 
      study was to evaluate our management algorithm. METHODS: Thirty-eight adult 
      patients with left-sided infective endocarditis undergoing valve surgery were 
      analyzed. Before the operation, enhanced brain computed tomography (CT) was 
      performed to rule out a cerebral complication. Pre and postoperative data were 
      retrospectively reviewed to clarify whether our algorithm was effective. Sixteen 
      patients having neurological complication (CVC group) were compared with 22 
      patients without neurological complication. RESULTS: Age, sex, New York Heart 
      Association (NYHA) functional class, affected valve and pathogens were not 
      different between two groups. Mean interval from the onset of neurological 
      dysfunction to cardiac operation was 27.8 +/- 27.8 days (median 23 days). Of the 16 
      CVC group patients, 12 experienced cerebral infarction. Mass effects were seen in 
      3 patients, with 1 of these 3 patients died following aneurysm rupture. Mycotic 
      aneurysm was detected in 4 patients, with 3 undergoing successful staged 
      operations. Mortality and postoperative neurological exacerbation in CVC group 
      was 6.3% (1 patient). Most patients who fulfilled the algorithm showed good 
      outcomes. CONCLUSIONS: Our suggested management algorithm for infective 
      endocarditis appears effective.
FAU - Fukuda, Wakako
AU  - Fukuda W
AD  - Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate 
      School of Medicine.
FAU - Daitoku, Kazuyuki
AU  - Daitoku K
FAU - Minakawa, Masahito
AU  - Minakawa M
FAU - Fukui, Kozo
AU  - Fukui K
FAU - Suzuki, Yasuyuki
AU  - Suzuki Y
FAU - Fukuda, Ikuo
AU  - Fukuda I
LA  - eng
PT  - Journal Article
DEP - 20130405
PL  - Japan
TA  - Ann Thorac Cardiovasc Surg
JT  - Annals of thoracic and cardiovascular surgery : official journal of the 
      Association of Thoracic and Cardiovascular Surgeons of Asia
JID - 9703158
SB  - IM
MH  - Adult
MH  - Aged
MH  - Algorithms
MH  - Aneurysm, Infected/microbiology/mortality
MH  - *Cardiac Surgical Procedures/adverse effects/mortality
MH  - Cerebral Angiography/methods
MH  - Cerebral Infarction/microbiology/mortality
MH  - Cerebrovascular Disorders/diagnosis/*microbiology/mortality
MH  - Critical Pathways
MH  - Endocarditis/complications/diagnosis/microbiology/mortality/*surgery
MH  - Female
MH  - Heart Valve Diseases/complications/diagnosis/microbiology/mortality/*surgery
MH  - Humans
MH  - Intracranial Aneurysm/microbiology/mortality
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/mortality
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Time-to-Treatment
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
EDAT- 2013/04/06 06:00
MHDA- 2015/02/20 06:00
CRDT- 2013/04/06 06:00
PHST- 2013/04/06 06:00 [entrez]
PHST- 2013/04/06 06:00 [pubmed]
PHST- 2015/02/20 06:00 [medline]
AID - DN/JST.JSTAGE/atcs/oa.13.02265 [pii]
AID - 10.5761/atcs.oa.13.02265 [doi]
PST - ppublish
SO  - Ann Thorac Cardiovasc Surg. 2014;20(3):229-36. doi: 10.5761/atcs.oa.13.02265. 
      Epub 2013 Apr 5.