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June 27th, 2012 
FAKE NEWS for the Zionist agenda WEDNESDAY, June 27 (HealthDay News) — People with an advanced
form of a heart infection called endocarditis may do better if they
undergo early surgery than if they are treated with antibiotics initially,
a new study suggests.
Infective or bacterial endocarditis occurs when bacteria settles in the
heart lining or heart valve. In advanced cases, the abnormal bacterial
growth, often called vegetation, can be large enough to break off and
travel elsewhere in the body, such as to the brain, where it may cause a
stroke. Advanced infective endocarditis can also damage the heart valve.
People with existing heart disease or heart-valve problems are most
likely to develop endocarditis.
In a new study published June 28 in the New England Journal of
Medicine, researchers evaluated close to 80 people, average age 47,
with advanced infective endocarditis.
Of these, 37 had early surgery within 48 hours of their diagnosis, and
39 received conventional therapy with antibiotics while they were
monitored to see if the infection abated. Thirty people placed in the
conventional treatment group eventually had surgery.
Early surgery reduced the risk of developing an embolism (or clot) and
did not increase the risk of in-hospital death, the study showed.
After six months, the rate of adverse events, including death, repeat
hospitalization for congestive heart failure or a recurrence of
endocarditis, was 3 percent in the early-surgery group versus 28 percent
in the conventionally treated patients.
“Early surgery can be the preferred option to further improve clinical
outcomes of infective endocarditis, which is associated with considerable
morbidity and mortality,” said study author Dr. Duk-Hyun Kang, a
cardiologist at University of Ulsan College of Medicine in Seoul, South
Korea.
“If a patient with infective endocarditis has large vegetations and
severe valve disease, we would advise them to request early referral to
medical centers with adequate experience and resources for early surgery,”
Kang said.
Surgery for infective endocarditis aims to remove all infected tissue,
repair the heart tissue and repair or replace the affected valve.
Others experts said only certain patients would warrant early
surgery.
The new study “showed that patients with the combination of large
vegetations and valve dysfunction, even if they are stable and not in
heart failure, have a high risk of suffering serious embolic events or to
progress to heart failure with need for emergency surgery and that early
surgery prevented these complications,” said Dr. Gosta Pettersson,
co-author of an accompanying journal editorial and vice chair of thoracic
and cardiovascular surgery at the Cleveland Clinic in Ohio.
Surgery does have its share of risks, however. “Historically, surgery
for infective endocarditis was high-risk surgery, and the risk of
recurrent infection on the replacement valve was also high,” he said.
“Today, several publications have demonstrated that the added risk of
operating on a patient with active infection has been more or less
neutralized,” Pettersson added.
Surgeons have become adept at removing all infected tissue and foreign
material and determining how best to reconstruct the heart, he explained.
“Taking care of this patient is a team work with close collaboration
between infectious disease specialists, cardiologists and cardiac
surgeons,” he said. Importantly, he noted, “surgery is a complement to
antibiotics not an alternative.”
Not everyone with infective endocarditis should have surgery,
Pettersson said. For example, the stable patient with small vegetations,
preserved valve function and growth of bacteria sensitive to antibiotics
does not need surgery. Severely ill patients who are unlikely to survive
an operation or those who have irreversible brain damage from embolism
would not be surgical candidates either, he pointed out.
Dr. Stephen Green, chief of cardiology at North Shore University
Hospital in Manhasset, N.Y., said that the new findings only apply to a
select few. “Patients in the study had very large vegetation and severe
valve pathology,” Green said. “These tend to be the worst of the
worst.”
Most people with infective endocarditis are treated with antibiotics.
“We reserve surgery for people whose infections don’t resolve, have fever
or bacteria in the bloodstream or whose valves get destroyed,” Green
noted.
“Many people with milder forms can be treated with antibiotics and
monitored long term to see if they need surgery,” he added. This study
suggests that “if you get a really bad clump of stuff on a valve, even if
it’s antibiotic-sensitive, maybe we should go to surgery earlier.”
More information
Learn more about infective endocarditis at the American Heart Association.
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