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Which of these below are indications for emergency cardiac surgery in a patient with infective endocarditis?
1. Staphylococcus lugunesis in a patient with a h/o endocarditis.
2. Culture positive & resistant organism with septic PE.
3. Prosthetic valve endocarditis 4 mths after surgery.
4. Fungal endocarditis proven by cultures.
5. Ruptured Sinus of Valsalva abscess into Rt heart.
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4. Fungal endocarditis proven by cultures.
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to my knowledge it is 444 ,as fungal etiology ,so surgery
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The Ans is 5...Ruptured Sinus of Valsalva abscess into Rt heart
- Both Culture-proven fungal (particularly mold) endocarditis and sinus of Valsalva abscess supports cardiac surgery
- A ruptured sinus of Valsalva abscess represents a surgical emergency, while fungal endocarditis is usually considered more of an elective case, with earlier surgical management preferred.
- Acute AR + preclosure of the mitral valve is also an indication for immediate surgery.
- Septic pulmonary emboli alone is not an indication for surgery; however, if a 10-mm vegetation is also seen this would best be treated surgically.
- Staphylococcal prosthetic valve endocarditis (PVE) or PVE within 2 months of surgery is an example of reasonable indications for surgical management. In contrast to fungal endocarditis, there are no particular species of bacteria that merit surgical treatment, independent of other factors.
