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Abstracts |

Prosthetic Valve Replacement in Active Bacterial Endocarditis.

Don W. Chapman, M.D., F.A.C.P.; William L. Winters Jr., M.D., F.A.C.P.; H. Liston Beazley, M.D., F.A.C.P.; Paul K. Peterson, M.D.; Temple W. Williams, M.D., F.A.C.P.; and Jimmy F. Howell, M.D.
Ann Intern Med. 1969;70(5):1074. doi:10.7326/0003-4819-70-5-1074_2
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In 19 cases of active bacterial endocarditis terminal heart failure necessitated prosthetic valve replacement. The organisms included five due to alpha streptococci; two, gamma streptococci; three, pneumococci; and four due to staphylococci; in five the organism was undetermined. Hemodynamic studies revealed predominently severely regurgitating valves, elevated right-sided pressures, and low cardiac output. There were ten patients with aortic insufficiency who survived, both of the mitral valve patients lived, and one of the three combined mitral and aortic valve patients survived. Vegetations and leaflet perforation were constant findings, and abscess at the base of the valve made it difficult to suture


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