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Treatments

It is important to treat endocarditis. Left untreated, it can damage your heart valves and destroy your heart's inner lining. This can lead to heart failure.

Hospital Treatment and Medical Therapy

Treatments typically involve:

  • High doses of IV antibiotics in the hospital
  • Blood tests to identify the type of bacteria involved and the proper antibiotic will be prescribed
  • Antibiotic treatments lasting up to six weeks:
    • This will require the placement of a IV catheter in your arm for the duration of your treatment
    • This is also known as a PICC (peripherally inserted central catheter) line

You will be monitored closely during and after treatment to ensure the infection is resolving.

Surgery

Sometimes, surgery is needed to repair or replace the damaged valve.

Traditional Aortic Valve Replacement Surgery

  • During traditional aortic valve replacement surgery, your surgeon makes a six-to-eight-inch incision through the center of your breastbone, dividing it to allow access to your heart.
  • In some cases, a partial sternotomy can be performed instead. This is a less invasive method of getting to the sternum, requiring a three-inch incision instead.
  • Once your sternum is divided and your pericardium -- the membrane that surrounds your heart -- has been opened, you are placed on a heart-lung machine (bypass). It takes over the task of breathing and pumping your blood while your surgeon replaces your heart valve.
  • Once you are on bypass, an incision is made in your aorta. Your surgeon then removes the diseased aortic valve and puts the replacement valve in its place.
  • Once the valve is in place and your aorta has been closed, you are taken off the heart-lung machine.
  • When the surgery is done, you will stay in intensive care for one to two days and remain in the hospital for a total of four to five days.

Types of Replacement Valves

Your damaged aortic valve can be replaced with either a valve taken or fashioned from a cow or pig's heart or with a mechanical valve made of carbon.

  • Bioprosthetic Valves
    • Aortic Valve Replacement—Mechanical (St. Jude) and Bioprostheses (Porcine) Valve ShownMade of porcine (pig) or bovine (calf) tissue.
    • Do not typically require blood thinners and have an average durability of 10-15 years.

  • Mechanical Valves
    • Made of carbon.
    • Last much longer than bioprosthetic valves.
    • Patients with them must take a blood thinner (Coumadin) for life due to an increased risk of blood clots forming.

You should talk with your surgeon about the pros and cons of both options.

Contact Information

Cardiovascular Medicine
Division of the CardioVascular Institute
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
617-667-8800

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