• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.241-247
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• 1985

Bacterial endocarditis has been well recognized as an important complication of congenital heart disease, such as ventricular septal defect, patent ductus arteriosus or pulmonary stenosis. The incidence of right sided bacterial endocarditis is lesser than left sided bacterial endocarditis. Also, pulmonic valve vegetation has been thought to be relatively uncommon. And pulmonary embolism is common in the patients with right sided bacterial endocarditis. So in a patient with fever and evidence of recurrent pulmonary infarction, changing heart murmurs and scattered pneumonic infiltrates, one should direct attention to the heart as a possible source of the infection. Echocardiography with M-mode, 2-D and Doppler mode represents the only noninvasive technic available for detecting vegetations in bacterial endocarditis. In fact, the technic is more sensitive in identifying these lesions than angiography. We experienced a case of ventricular septal defect with bacterial endocarditis, pulmonic valve vegetation and multiple pulmonary embolism diagnosed with Echocardiogram and lung scan, and confirmed by operation. Patch repair of ventricular septal defect, resection of pulmonic valve and vegetation and artificial valve formation with pericardium were done.

• Journal of Chest Surgery
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• v.27 no.6
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• pp.509-512
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• 1994

Congenital coronary arteriovenous fistula is a ~are condition, and with widespread use of cardiac catheterization, angiography and selective coronary arteriography is being recognized with increasing frequency. Surgical correction is strongly recommended to prevent the development of congestive heart failure,angina, subacute bacterial endocarditis, myocardial infarction, and pulmonary hypertension, as well as coronary aneurysm formation with subsequent rupture or embolization. I report a case of congenital coronary arteriovenous fistula of the left main coronary artery to the fight atrium in a 23 year old female, which is associated with bacterial endocarditis with right atrial vegetation.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.408-412
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• 2016

A 50-year-old female patient with visual disturbances was referred for further evaluation of a heart murmur. Fundoscopy revealed a Roth spot in both eyes. A physical examination showed peripheral signs of infective endocarditis, including Osler nodes, Janeway lesions, and splinter hemorrhages. Our preoperative diagnosis was subacute bacterial endocarditis with severe aortic regurgitation. The patient underwent aortic valve replacement and was treated with intravenous antibiotics for 6 weeks postoperatively. The patient made a remarkable recovery and was discharged without complications. We report this case of subacute endocarditis with all 4 classic peripheral signs in a patient who presented with visual disturbance.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.819-822
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• 1997

Aortic valve replacement with aortic allograft has been considered a treatment of choice for aortic valve disease secondary to bacterial endocarditis because of its good homodynamic performance and higher resistance to infection. The aortic root replacement technique might be superior to the subcoronary allograft implantation technique with regard to aortic regurgitation. A 46 yea,rs old male patient had acute aortic regurgitation with progressing heart failure secondary to acute bacterial endocarditis. The patient underwent emergent aortic root replacement using 20 mm aortic allograft. At operation, right coronary cusp perforation and heavy calcification of commissure between right and left coronary cusp were observed. The patient recovered well and postoperative echocardiography demonstrated no aortic regurgitation. Inflammatory signs were subsided after 8 weeks of antibiotics therapy. Medically uncontrolled acute bacterial endocarditis was treated successfully by aortic root replacement using aortic homograft.

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.123-131
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• 1996

Bacteremia occurs in a wide variety of clinical procedures in oral cavity. Reduction of the number of causative microorganisms of infective endocarditis in oral cavity by local administration of antimicrobial agents decreases the magnitude of bacteremia and possibility of infective endocarditis. The effects of chlorhexidine on Streptococcus sanguis, Streptococcus mitis, Streptococcus mutans, Streptococcus oralis, Streptococcus gordonii, Staphylococcus aureus, and Staphylococcus epidermis were investigated by measurement of turbidity. The effects of 0.1% chlorhexidine gargling for 7 days on oral bacterial flora, total streptococci, S. mutans, S. aureus, and S. epidermis in whole saliv a of 7 healthy human subjects, were investigated by measurement of Colony Forming Units (CFU). The obtained results were as follows : 1. Chlorhexidine showed significant antimicrobial effects on Streptococcus snaguis, Streptococcus mitis, Streptococcus mutans, Streptococcus oralis, Streptococcus gordonii, Staphylococcus aureus, and Staphylococcus epidermis. However, the effects on S. sanguis and S. gordonii were not apparent compared with other microorganisms. 2. Oral gargling of 0.1% chlorhexidine decreased the CFU values of normal oral bacterial flora, total streptococci, S. mutans, S. aureus, and S. epidermis in whole saliva. The antimicrobial effects were significant after 4 days of chlorhexidine gargling. 3. Local antimicrobial administration in addition to systemic antibiotic prophylaxis can be highly recommended as an effective adjunct regimen for prevention of infective endocarditis.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1238-1243
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• 1990

Bacterial endocarditis has been well recognized as an important complication of congenital heart disease. The most common. form of congenital heart disease is the VSD, of which natural history is spontaneous closure, pulmonary vascular disease, symptoms, and endocarditis. The incidence of endocarditis is relatively low. But endocarditis is almost universally fatal if untreated. Two cases of VSD with endocarditis, 4 \ulcorneryear male and 17 \ulcorneryear female, were treated at Department of Thoracic and Cardiovascular Surgery, Chonbuk National University. In the First case, the VSD was perimembranous type and vegetation located on the septal leaflet of the tricuspid valve. After 7 week medical treatment, simple closure of the VSD, removal of vegetation, and tricuspid annuloplasty were performed. In the second case. the VSD was subpulmonic type and the pulmonic valve was destructed due to vegetation. So the VSD was closed with interrupted 4 \ulcorner0 Prolene sutures and the pulmonic valve was excised. Postoperative course of all cases was uneventful.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.1009-1013
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• 1998

Bacterial endocarditis of the native aortic valve is associated with significant morbidity and mortality despite aggressive medical and surgical treatment, especially when perivalvular tissue was invaded and destructed. The pulmonary autograft is full viable and immune compatible tissue. This paper describes successful Ross operation as total root replacement in 38 years old native valve endocarditis patient with aortic root abscess.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.537-541
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• 1985

Recently, we met a 12 year old female patient who suffered from bacterial endocarditis and pericarditis which were complicated by patent ductus arteriosus. She was admitted to our hospital because of dyspnea, fever, headache, and generalized ache for 10 days. The initial diagnosis was bacterial endocarditis and pericarditis complicated by patent ductus arteriosus and congestive heart failure. At first, we tried to treat the patient medically with digitalis, diuretics, and massive antibiotics. On echocardiography large amount of pericardial fluid was accumulated mainly right anterior aspect and also noted a large vegetation at pulmonary valve area. With vigorous medical treatment including repeated pericardiocentesis, the patient showed no improvement. So we decided to perform pericardiectomy for elimination of the most probable septic focus. On operation, we encountered an unpredicted event, the pericardium was thickened, distended, and its surface showed pulsating which meant connecting to systemic circulation. We decided to close the operative wound and reoperate her under cardiopulmonary bypass later. On the next day, we operated her under cardiopulmonary bypass later. On the next day we operated her under cardiopulmonary bypass. The operative findings were ruptured main pulmonary artery about 1.5cm in diameter on its ventral portion, the blood from the ruptured main pulmonary artery was filled up the localized pericardial sac due to previous pericarditis. Through the ruptured main pulmonary artery, we also found 0.5cm diametered patent ductus arteriosus. With the aid of partial cardiopulmonary bypass and inserting 24F ballooned Foley catheter at aorta, pericardiectomy was performed first. After completion of the pericardiectomy, total cardiopulmonary bypass was established. With minimum pump flow [0.3L/min/m2] the PDA was closed with two Teflon-felted 4-0 Prolene interrupted sutures. The ruptured main pulmonary artery was also closed using thickened pericardium with three Teflon-felted 4-0 Prolene interrupted sutures. The operation was successful and postoperative course was uneventful. She was discharged on the 16th POD. We report this case as a very rare secondary complication of bacterial endocarditis complicated by patent ductus arteriosus.

• Journal of Veterinary Clinics
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• v.34 no.3
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• pp.213-217
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• 2017

A 1-year and 8-month-old male, thoroughbred horse showed fever ($39.8^{\circ}C$), cardiac murmur, tachycardia up to 80 beats/min, anorexia, depression and lameness for about 2 months. The dead horse was referred to pathology laboratory at the College of Veterinary Medicine in Jeju National University. At necropsy, Severe protruding multiple rough cauliflower-like yellowish red nodules ranged $5{\sim}6{\times}2{\sim}3cm$ in size were attached on the mitral valve of the left heart. A yellowish red long stick-shaped thrombus $15{\times}3.5{\times}1.5cm$ in size was also present inside the right ventricle. Multifocal infarcts were scattered in the myocardium and renal cortex. Histopathologic examination revealed that morphologic diagnosis were vegetative endocarditis, thrombus in right ventricle, infarcts in myocardium and kidney, pulmonary congestion and edema, and splenic congestion. The isolated bacteria from vegetative lesions and thrombus were confirmed as Escherichia (E.) coli based on the bacterial culture and VITEK 2 system. Based on the gross and histopathologic features, and bacterial test, this case was diagnosed as vegetative endocarditis with thrombus formation associated by E. coli in a thoroughbred horse.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.55-58
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• 1998

Surgical treatment is recommended in tricuspid valve endocarditis not responding to antibiotics or presenting severe heart failure. However, risk of early prosthetic valve endocarditis especially in drug addictors is principal concern in the treatment. A 37 year-old man with tricuspid valve endocarditis underwent staged operation of primary tricuspid valvulectomy and secondary bioprosthetic valve implantation successfully. We report it with references of literature.