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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A severe staphylococcal septicemia originating from an unknown focus occurred in a 17-year-old patient who had undergone a Rastelli-Ross operation 5 years earlier. The clinical course was complicated by extensive bilateral pneumonia, diffuse intravascular coagulation, and glomerulonephritis. After 4 weeks of intensive conservative treatment, including a daily regimen of 16 Gm. of cloxacillin, the patient was operated upon for a rapidly progressive false aneurysm, which had resulted from dehiscence of the anastomosis between the prosthesis and ventricle. The excised prosthesis proved to be sterile. The postoperative course was uneventful. Cloxacillin treatment was continued for 6 months, initially parenterally and later orally. After discontinuation of therapy, no signs of infection have occurred. Right-sided intracardiac or intravascular prosthetic material may be particularly susceptible to infections originating from the body surface.
J Thorac Cardiovasc Surg 1976 Jul
PMID:Prosthesis endocarditis: treatment of a case occurring five years after a Rastelli-Ross operation. 13 78

A review was made of the presentation, treatment, and follow-up of 20 patients with adenoid cystic carcinoma and 12 patients with mucoepidermoid carcinoma of the bronchus who were seen at the Mayo Clinic during the 50 year period 1927 through 1977. Three forms of therapy were employed: complete surgical resection, radiation therapy alone, and radiation therapy after endoscopic removal of tumor tissue. Superior results were obtained in the group with adenoid cystic carcinoma, when complete resection was possible. Significant survival and palliation of sepsis was achieved with subtotal resection. The mucoepidermoid carcinomas in this series were classified on the basis of histologic differentiation. Mucoepidermoid carcinoma of Grade 1 was managed by conservative pulmonary resection. Mucoepidermoid carcinoma of Grades 2 and 3 showed a greater propensity for malignancy. Widespread dissemination caused death with unresectable high-grade mucoepidermoid carcinomas of Grades 2 and 3.
J Thorac Cardiovasc Surg 1978 Sep
PMID:Adenoid cystic carcinoma (cylindroma) and mucoepidermoid carcinoma of the bronchus. Factors affecting survival. 21 Mar 33

A case in which Serratia marcescens septicemia complicated the insertion of a transvernous pacemaker unit is reported. Appropriate antibiotic therapy and removal of the pacemaker electrode are two essential steps to achieve a complete cure in this stimulation. Open cardiotomy with total cardiopulmonary bypass provides a safe approach for withdrawal of an incarcerated electrode and is justified because of the lethal potential of systemic Serratia infections, particularly those superimposed on intracardiac prostheses.
J Thorac Cardiovasc Surg 1977 Mar
PMID:Retention of pacemaker electrode complicated by Serratia marcescens septicemia. Removal with total cardiopulmonary bypass. 32 Mar 97

Infection of an intravenous pacemaker electrode developed in a 78-year-old man after multiple replacements and revisions of the pulse generator and the pacemaker lead. Spread of the infective process to the endocardium was followed by septicemia with Serratia marcescens and Staphyloccus epidermids. Failure of medical treatment and external traction on the pacemaker electrode led to thoracotomy and removal of the pacemaker electrode wires with the use of extracorporeal circulation. The tip of one of the pacemaker electrodes was found imbedded in the wall of the right ventricle and attached to the base of the tricuspid valve. Cultures from the endocardium removed with the electrode rendered the same organisms as cultured preoperatively. There has been no recurrence after 2 years following the removal of the infected electrodes. Although the problem described herein is not frequently found, radical treatment becomes necessary whenever infection and septicemia develop.
J Thorac Cardiovasc Surg 1977 May
PMID:Septicemia secondary to impacted infected pacemaker wire. Successful treatment by removal with cardiopulmonary bypass. 32 83

This communication describes a new surgical procedure of enlarging the narrow aortic valve ring by extending the aortic incision through the fibrous origin of the aortic leaflet of the mitral valve into this leaflet. A fusiform patch is sutured to the V-shaped defect in the aortic leaflet of the mitral valve and in the aortic anulus. This procedure permits the replacement of the aortic valve by a suitable prosthesis. Between June of 1976 and February of 1978, eight patients underwent this surgical procedure. At the time of operation the patients were between 8 and 50 years old. The estimated enlargement of the aortic root ranged from 10 to 25 mm. The operative technique is described, peculiarities of this method are discussed, and the results are reported. Six to 27 months following operation, the clinical condition of six patients is good. Four patients show no impairment of mitral valve function. In one case, preoperatively diagnosed mitral incompetence persists. In another patient the pericardial patch broke from the aortic leaflet of the mitral valve, so that the valve had to be replaced on the fourth postoperative day. One patient died of myocardial necrosis because of insufficient myocardial protection during operation. One child with acute aortic insufficiency caused by staphylococcal endocarditis and congestive heart failure died of septicemia 3 months postoperatively. Mitral incompetence was not detectable in this child.
J Thorac Cardiovasc Surg 1979 Sep
PMID:Patch enlargement of the aortic valve ring by extending the aortic incision into the anterior mitral leaflet. New operative technique. 47 Apr 20

During the past decade 44 patients with active endocarditis, defined as valvular infection requiring operative intervention before completion of a planned course of antibiotic therapy, have been treated at Stanford University Medical Center. Twenty-seven patients had infection of a native valve (primary endocarditis) and 17 had infection of a previously implanted intracardiac prosthesis. In 91 per cent of cases urgent valve replacement was dictated by rapid hemodynamic deterioration and in the remainder by recurrent macroemboli or persistent sepsis. Various species of Streptococcus were the most common organisms encountered, followed by Staphylococcus aureus. Unusual bacteria were mostly limited to patients with prosthetic infections; Candida was seen in both groups. Aortic valve replacement was required in 80 per cent of patients. Operative mortality rates were 30 per cent in the group with primary disease and 24 per cent in the group with disease of the prosthetic valve. Most deaths were attributable to multiple system complications generated preoperatively and were unrelated to duration of preoperative antibiotic administration. Five-year survival rates for operative survivors were 68 per cent (primary) and 54 per cent (prosthetic). This experience illustrates the potential therapeutic benefit of operative intervention during active infective endocarditis complicated by severe heart failure or other life-threatening events.
J Thorac Cardiovasc Surg 1976 May
PMID:Operative treatment of active endocarditis. 77 23

One hundred seventy-seven patients were admitted to the New York University Medical Center from 1970 through 1975 with infective endocarditis. Fifty-four of these patients required surgical treatment. The over-all mortality rate was 28 per cent. Two thirds of the deaths were early (10 patients) and one third late (5 patients). The mortality rate was 90 per cent in 10 patients treated for 4 to 6 weeks in whom the infection was uncontrolled and the clinical condition was deteriorating. However of the 12 patients with uncontrolled infection who were operated upon promptly within 10 days, 83 per cent survived. The fact that fungal and gram-negative infections responded poorly to medical therapy suggests the need for prompt, early surgical intervention. The mortality rate in the 32 patients operated upon in whom the infection was controlled was 12.5 per cent. It is our conclusion that all patients with infective endocarditis who develop progressive congestive failure, recurrent embolization, or progressive sepsis, despite treatment, shold have prompt valve replacement within 7 days of the institution of appropriate antimicrobial therapy.
J Thorac Cardiovasc Surg 1977 Jan
PMID:Infective endocarditis. An analysis of 54 surgically treated patients. 83 Oct 8

Fistulous communications between the bowel and arterial grafts present difficult problems in diagnosis and management. The majority of these cases exhibit retroperitoneal sepsis but in some instances communication between the bowel and the lumen of the arterial graft produces serious hemorrhage. In contrast, the current report describes a patient in whom bleeding occurred twelve years after insertion of an aortorenal graft and the source of bleeding was arterial erosion of an ulcer in the duodenal wall rather than an aortoenteric fistula. Removal of the graft, closure of the ulcer, and nephrectomy were effective in treating the bleeding ulcer and the renovascular hypertension.
J Cardiovasc Surg (Torino)
PMID:Duodenal erosion by aortorenal dacron graft. 83 95

A randomized, prospective study of the relative effectiveness of broad-spectrum versus specific antistaphylococal antibiotic prophylaxis in patients having open-heart surgery was performed between May, 1972, and June, 1973. All patients undergoing open-heart surgery was assigned randomly (by hospital number) to receive either methicillin or cephalothin beginning the night before operation. There were 132 patients in the cephalothin group and 129 in the methicillin group. There was no statistically significant differences in age or duration of hospitalization, cardiopulmonary bypass, urinary tract drainage, or postoperative fever. There was a significant difference in the ratio of male to total patients (cephalothin group, 0.67; methicillin group, 0.52; p less than 0.02) and duration of operation (cephalothin group, 4.27 hours; methicillin group, 3.87 hours; p less than 0.05). The methicillin group had a statistically significant higher rate of urinary tract infection (cephalothin group, 3 cases; emthicillin group, 22 cases, p less than 0.05), pneumonia (cephalothin group, no cases; methicillin group, 9 cases; p less than 0.01), and episodes of sepsis and prosthetic valve endocarditis (cephalothin group, no cases; methicillin group, 11 cases, p less than 0.001). The incidence of wound infections and positive blood cultures from blood obtained immediately after termination of cardiopulmonary bypass was not significantly different between the two groups. Cephalothin has replaced methicillin as the routine prophylaxis for open-heart surgery at our institution.
J Thorac Cardiovasc Surg 1977 Apr
PMID:Antibiotic prophylaxis for open-heart surgery. 83 52

Two cases of sepsis following ventricular aneurysmectomy are presented. In both, the source of sepsis was an infected caridac suture line in which Teflon felt strips were used to reinforce the closure. One patient had a pseudoaneurysm and a chronic empyema of the left side of the chest, and the second had a ventriculocutaneous fistula. Early operation with removal of the foreign body is warranted in this major complication of a ventricular aneurysmectomy.
J Thorac Cardiovasc Surg 1976 Aug
PMID:Infection of cardiac suture line after ventricular aneurysmectomy. Report of two cases. 95 42


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