VALVE EXCISION ONLY VERSUS VALVE EXCISION PLUS REPLACEMENT FOR ACTIVE INFECTIVE

本文探讨了非小细胞肺癌的首选外科治疗方法问题。 累及三尖瓣的活动性感染性心内膜炎 静脉注射吸毒者。报告了两位患者：1)接受了瓣膜手术 切除同期置入瓣膜生物假体 生物假体的再次感染需要进行植入术。 充血性心力衰竭的再发展需要放置第二个 生物假体效果良好。第二名患者接受了切除手术。 只是此后一直处于无症状状态直到他死于 11个月后服药过量。本文对这一疗法的文献进行了综述。 两难境地的结论是，切除感染的三尖瓣 单纯瓣膜切除优于同时行人工瓣膜切除 意识到充血性心力衰竭可能会使 部分患者最终需要放置瓣膜假体。

This paper examines the question of the preferred surgical treatment for active infective endocarditis involving the tricuspid valve among intravenous drug users. Two patients are presented: 1) underwent valve excision with concomitant valve bioprosthesis placement with rapid reinfection of the bioprosthesis necessitating its explantation. Redevelopment of congestive heart failure required placement of a second bioprosthesis with good results. The second patient underwent excision only with an asymptomatic state thereafter until the time of his death from overdose 11 months later. The literature is reviewed on this therapeutic dilemma with the conclusion being that excision of the infected tricuspid valve alone is preferable to excision with concurrent prosthetic replacement with the realization that congestive heart failure may make eventual valve prosthesis placement necessary in a subset of patients.