Operative treatment of acute valve
endocarditis with paravalvular
abscess remains a surgical challenge. The aim of the study was gaining insights into the influence of our surgical strategy on the short- and midterm results. Over a period of 7 years 18 patients underwent surgical treatment of a paravalvular
abscess accompanying their acute aortic valve
endocarditis. All patients ranged preoperative in the NYHA class IV. Eleven patients suffered from native and 7 from prosthetic aortic valve
endocarditis. Staphylococcus aureus was found to have caused the
infection in 50% of the cases. Surgical
therapy consisted in all patients of thorough resection of the infected tissue followed by reconstruction of the defect with the aid of autologus pericardial patch and replacement of the aortic valve using a
prosthesis. Although the rate of complications continued high early lethality remained at 5.5%. Midterm results proved to be very good with a follow-up of 44 month. Both lethality and the reoperation rate stayed at 0%. The operative risk of acute aortic valve
endocarditis with paravalvular
abscess is high but acceptable. Should a paravalvular
abscess be diagnosed during a case of
endocarditis urgent surgical
therapy is highly advisable even there is only a minor deterioration of the patient' clinical state. Radical
abscess debridement in combination with exclusion of the place of resection from circulation using an autologus pericard patch is a necessary condition for achieving good results.