[HSF] Endocarditis with splenic infarct

[prasannasimha]

It has a lower rate of recurrence if debridement is radical and you can 
use a Glutaraldehyde treated pericardial ring too to reduce the amount 
of foreign material. Tirone David and   Calafiore have published their 
results which are excellent. It is important to remove all infected 
tissue. Also I have tanned edges of flimsy tissues with Glutaradehyde 
when there is particularly flimsy areas so sutures hold well.(In fact I 
also saw Carpentier doing the same  in a live teleworkshop.). The caveat 
is excise first adequately and then decide what you will do.
Obviously this is not what you would like to do as an early repair case 
or if done infrequently but then becomes appealing (and in fact seems 
safer) when repair becomes the norm in ones armamentarium.
Prasanna
Hgrmd at aol.com wrote:
> Dear Nand,
>   Though it sounds scary, repairing a mitral valve in the face of  active 
> endocarditis is safe with a low likelihood of recurrence in my  experience.  
> After doing the radical debridement, I then hand off the  instruments used to 
> resect the infected tissue.  Next, I paint the resected  area with Betadine.  
> Finally, I reconstruct as per usual.  This policy  works quite well if the 
> infection is relatively confined.
> Hal
>
>
>
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