Management for Active Infective Endocarditis with extensive aortic root abscess

Results Our surgical strategy for active IE is 1) complete debridement of infective tissue, 2) reconstruction with biological material. Six cases of 21 required reconstruction of the aorto-mitral continuity using butterfly shaped bovine pericardial patch in 4, and mono bloc aorta-mitral tissue valves replacement in 2. For the other 15 cases, resected aortic annulus were reconstructed using pericardial patch thereafter reconstruction of aortic leaflets in 6 and tissue valve replacement in 9. For two cases of excessive root abscess, mitral valve was also infective with vegetation. In these two, after resection of infective tissue including aorto-mitral curtain was completed, Monobloc aorto-mitral biological valve prosthesis was assembled with implanting both aortic and mitral prostheses on a Dacron sheet. The monobloc prosthesis was implanted on the remaining intact aortic and mitral annulus. In all, septic status was completely disappeared after surgery. In 6 case of annulus reconstruction, the second surgery was required because of residual shunt in 2, PVL in 4. Two cases died from brain infarction in one and congestive heart failure in one.