scholarly journals Surgical treatment of multi-valve heart disease of infective endocarditis

2021 ◽  
pp. 40-49
Author(s):  
Khamidulla ABDUMADJIDOV ◽  
Hijran BURANOV ◽  
Iskender BAYBEKOV ◽  
Bois SAIDKHANOV ◽  
Abdulla ALIMDJANOV
Keyword(s):  
Heart Disease ◽  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Preventive Measures ◽  
Clinical Results ◽  
Control Group ◽  
Study Group ◽  
X Rays ◽  
Infected Area ◽  
Valve Heart Disease

Peculiarities of diagnosis and results of surgical treatment of multi-valve heart disease in infective endocarditis. Analyze data and clinical results operated 156 patients with infective endocarditis, of which 85 were men (56.5%), and women -71 (45.5%). Age Our patients ranged from 12 to 68 (mean 32.76 ± 1.6) years. Diagnosis was based on the classiϐication and criteria Durack D.T. The patients were divided into 2 groups: group 1, 89 (57.4%) patients who underwent a complex developed by the authors of antibiotic therapy, treatment and preventive measures. 2-group 67 (42.6%) patients who underwent the traditional surgical treatment scheme. The diagnosis used: electrocardiography (ECG), X-rays from Skopje, transthoracic echocardiography (TTEHOKG) - all patients, transesophageal echocardiography (TEHOKG) - at 40.5%; coronaroventriculography (CVG) and angiocardiography (ACG) - at 12.65%; blood culture study in 38.6% of patients, with light gistrology electron microscopy (LEM) - in 47.5% of patients.Intraoperative treatment - preventive measures (TPM) were as follows; mechanical and chemical sanitation of the infected area of the heart; valve implantation antibakteriyalnymi properties; hyperthermic perfusion; anti microbial therapy, including anti-fungal agents. Application of the above measures could reduce mortality in the study group and 5.1% in the control group - 9.3%. In dynamics, declined to 3.9% in the last Godi mortality in the study group.

scholarly journals Surgical treatment of multi-valve heart disease of infective endocarditis

2017 ◽  
Vol 1 (Issue 2) ◽  
Author(s):  
Hamidullah Abdumadzhidov ◽  
Hayrullah Buranov ◽  
Ilkhom Huzhakulov ◽  
Ikrom Mirhodzhaev
Keyword(s):  
Heart Disease ◽  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Valve Heart Disease

CARDIOVASCULAR RISK FACTORS PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION AND CHRONIC INFLAMMATORY LUNG DISEASES

2020 ◽  
pp. 21-25
Author(s):  
Tupitsyn V.V. ◽  
Bataev Kh.M. ◽  
Men’shikova A.N. ◽  
Godina Z.N.
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Digestive System ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Internal Organs ◽  
History Of

Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.

scholarly journals POS0016 THE EVALUATION OF FUNCTIONAL ABILITIES OF PATIENTS WITH OSTEOPOROTIC VERTEBRAL FRACTURES AS A BASIS FOR REHABILITATION PROGRAMS DEVELOPING

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 209.2-210
Author(s):  
L. Marchenkova ◽  
V. Vasileva ◽  
M. Eryomushkin
Keyword(s):  
Muscle Strength ◽  
Vertebral Fractures ◽  
Trunk Muscles ◽  
Control Group ◽  
Study Group ◽  
Primary Osteoporosis ◽  
X Rays ◽  
Functional Abilities ◽  
Rehabilitation Programs ◽  
Osteoporotic Vertebral Fractures

Background:Due to the demand for special rehabilitation programs for patients with osteoporotic vertebral fractures (VFs), it is of interest to study the functional abilities of those patients. The scientific hypothesis suggests that osteoporotic VFs would cause muscle weakness, muscle dysfunction and conditional disturbances.Objectives:to estimate muscle strength, motor function and coordination disorders in patients with VFs in the setting of systemic osteoporosis as a basis for rehabilitation programs developing.Methods:120 patients aged 43−80 with primary osteoporosis were enrolled. Study group comprised of 60 subjects (56 women, 4 men) with at least 1 VF confirmed by X-rays. Control group included 60 subjects (56 women, 4 men) with osteoporosis but without any osteoporotic fracture. The examination program included back muscles tenzodynamometry, balance tests and stabilometry.Results:Muscle strength deficiency was estimated in study group in trunk flexors (TF) — 40.9% and in trunk extensors (TE) — 18.1% with an adequate function of the left lateral flexors (LLF) and in right lateral flexors (RLF). Patients with VFs had the lower muscle strength vs controls of TE (15.64±9.8 vs 27.73±9.9 kg, p=0.00002), TF (14.61±8.98 vs 21.28±8.38 kg, p=0.0006), LLF (13.10±7.2 vs 24.06±8.9 kg, p=0.005) and RLF 13.44±7.43 vs 24.26±7.65 kg, p=0.0003). Patients with VFs lose their balance faster during one-leg-standing test with open eyes (5.0 [1.0; 10.0] vs 7.5 [5.0; 10.5] sec in control group, p=0.03) and with closed eyes (2.0 [0; 3.0] vs 3.5 [3.0; 5.0] sec, p=0.04). Fukuda-Unterberger test showed greater side dislocation in study group — 40° [25; 45] vs controls 30° [10; 45], (p=0.02). According to stabilometry study group was characterized vs control group by lower balance coefficient with open eyes (77.2±7.6 vs 85.7±9.4%, p=0.002) and with closed eyes (67.1±9.8 vs 73.4±9.9%, p=0.03), greater sagittal displacement (6.8 [2.1; 37.7] vs 4.8 [1.8; 10.7] mm, p=0.025) and deviation in the saggital plane (1.2 [-1.07; 1.5] vs -1.2 [-1.5; 1.2] mm, p=0.01), and also less pressure center velocity (9.51±4.4 vs 7.1±2.7 mm/sec, р=0.009).Conclusion:Osteoporotic VFs are associated with reduction of trunk muscles strength and negatively affect static and dynamic balance function that should be taken into account when developing rehabilitation programs for these patients.Disclosure of Interests:None declared.

scholarly journals Evolution of diagnosis and surgical treatment of intra-abdominal infiltrates, abscesses of primary and postoperative origin in patients

2021 ◽  
pp. 15-29
Author(s):  
V.V. Skyba ◽  
◽  
V.F. Rybalchenko ◽  
A.V. Ivanko ◽  
R.М. Borys ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Postoperative Mortality ◽  
Multiple Organ ◽  
Long Term Results ◽  
Control Group ◽  
Study Group ◽  
Perforated Gastric Ulcer

Purpose – to improve the results of surgical treatment of patients with intra-abdominal infiltrates and abscesses through the introduction of the latest imaging methods and surgical technologies. Materials and methods. In the clinic of the Department of Surgical Diseases No 1, on the basis of the Surgery Center of the Kyiv City Clinical Hospital No. 1 from 2006 to 2019 218 patients with primary and secondary intra-abdominal infiltrates, abscesses and fluid formations were treated. The patients’ age ranged from 16 to 85 years. There were 107 (49.08%) male patients, 111 (50.92%) female patients. Depending on the time of hospitalization (by years), the patients were divided into two groups: the control group (CG) (2006–2012) 117 (53.67%) patients and the study group (SG) (2013–2019) 101 (46.33%) patients. The SG used the latest imaging technologies and improved methods of surgical treatment. Results. The patients were divided into two groups: primary in 191 (87.61%) and secondary postoperative infiltrates and abscesses in 27 (12.39%). The causes of primary infiltrates and abscesses were: complicated forms of appendicitis in 74 (33.94%), perforated stomach and duodenal ulcer in 48 (22.02%), complicated forms of cholecystitis in 69 (31.65%). Postoperative infiltrates and abscesses were observed in 27 (12.39%) patients who underwent urgent surgery: adgeolysis of adhesive ileus in 14 (6.42%) and complicated hernias of various localization in 13 (5.97%). Postoperative complications were diagnosed in 43 (19.72%) patients, of whom 34 (15.59%) from the surgical wound and 29 (15.18%) of the abdominal cavity, who required relaparotomy or laparoscopy, with destructive appendicitis in 10 (13.51%), perforated gastric ulcer and 12 duodenal ulcer in 6 (12.5%), destructive cholecystitis in 9 (13.04%), adhesive intestinal obstruction in 13 (19.12%) and with strangulated and complicated hernias in 14 (17.28%) of the examined patients. During relaparotomy, incompetence of the intestinal wall and intestinal sutures was established in 11 out of 32 patients, an ileostomy was imposed in 7, and cecostomy in 1 patient. Actually, in the control group, 8 (6.84%) patients died on the background of ongoing peritonitis, thrombosis of mesenteric vessels and multiple organ failure and concomitant ailments and in the study group 4 (3.96%) patients died. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis of 69 (36.13%) patients, 48 (25.13%) had laparotomy and 21 (11.00%) had laparoscopic examination. The use of the latest imaging and treatment technologies: Doppler ultrasonography, hydrojet scalpel and laparoscopy in 64 (33.51%), allowed to have better near and long-term results and to reduce postoperative mortality from 6.84% to 3.96%, with an average of 5.5%. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: destructive appendicitis, cholecystitis, perforated gastric ulcer and 12-duodenal ulcer, adhesive leakage, strangulated hernias, diagnosis and treatment.

scholarly journals Comparison of Clinical Efficacy of Ticagrelor and Clopidogrel for Treatment of Coronary Heart Disease with Myocardial Ischemia

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Shuo Huang
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Shear Rate ◽  
Myocardial Ischemia ◽  
Clinical Efficacy ◽  
Control Group ◽  
Study Group ◽  
Clinical Indicators ◽  
Whole Blood Viscosity ◽  
St Segment

Objective: To compare clinical efficacy of ticagrelor and clopidogrel for treatment of coronary heart disease with myocardial ischemia to provide references for later phase of clinical treatment. Methods: Ninety-six coronary heart disease patients with myocardial ischemia admitted to our hospital from July 20 to July 2019 were recruited as subjects. They were randomly divided into study group and control group according to parity of case number, with 48 patients in each group. Control group was given treatment with clopidogrel, while patients in study group were given treatment with ticagrelor. Clinical efficacy was compared between the both groups. Results: Comparison showed that total effective rate of clinical treatment was higher in study group when compared to control group (P<0.05). Frequency of ST segment depression, duration of ST segment depression, systolic blood pressure, diastolic blood pressure, heart rate and other clinical indicators in study group were superior to control group (P<0.05). Whole blood viscosity at low shear rate, whole blood viscosity at high shear rate, plasma viscosity shear rate, total cholesterol, triglyceride and other haemorheological parameters in study group were superior to control group (P<0.05). Conclusion: Application of ticagrelor has higher clinical efficacy than clopidogreal for coronary heart disease patients with myocardial ischemia. Clinical indicators and haemorheological parameters of myocardial ischemia patients were significantly improved. It should be promoted for application.

scholarly journals Oral Hygiene in a Sample of Children/Adolescents Living in Family-Homes from the Province of Milan (Italy): A Pilot Study

2020 ◽  
Vol 8 (2) ◽  
pp. 33 ◽  
Author(s):  
Alessandro Nota ◽  
Floriana Bosco ◽  
Shideh Ehsani ◽  
Francesca Giugliano ◽  
Giulia Moreo ◽  
...  
Keyword(s):  
Pilot Study ◽  
Oral Hygiene ◽  
Clinical Results ◽  
Plaque Index ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Study Group ◽  
Significant Difference ◽  
And Gender ◽  
Oral Hygiene Instructions

Objective: This pilot study is a prospective controlled clinical trial, designed to evaluate the short-term clinical results (the plaque index) of an educational/motivational program for home oral hygiene, directed to children and adolescents who live in family-homes. Methods: The setting of the project was the province of Milan (Italy), where two family-homes were selected. The study group included 26 children (16 females and 10 males) aged between 7 and 15 years, of Italian nationality, from the family-home communities. The control group included 26 children (15 females and 11 males, aged between 7 and 15 years) of Italian nationality, matched for age and gender distribution with the study group, that were not in a socially disadvantaged condition. Collection of the plaque index (PI) was performed at t0. Then, all basic oral hygiene instructions were given to all children/adolescents and their educators. Education and motivation were repeated in the same way after 4–7 weeks (T1), and after 10–12 weeks (T2). The PI was taken also at T1 and T2. Results: An improvement in the PI was generally found in both groups, but there was no statistically significant difference between the two groups over time. Multivariate analysis of variance (MANOVA) revealed a statistically significant effect of time [F (1, 52) = 90.73, p < 0.001], regardless of the assignment group, in consequence of which the plaque index presented a moderate and significant improvement. Conclusion: The present data confirm the validity of the educational/motivational program to improve oral hygiene in children/adolescents, regardless of the assignment group.

scholarly journals ONE-YEAR RESULTS OF BRACING FOR PATELLO-FEMORAL OSTEOARTHRITIS. PROSPECTIVE RANDOMIZED STUDY

2021 ◽  
Vol 29 (3) ◽  
pp. 127-131
Author(s):  
MATHEUS GARCIA LOPES MERINO ◽  
VICTOR MORALE ◽  
GUILHERME PEREIRA OCAMPOS ◽  
MARIA CÂNDIDA MIRANDA LUZO ◽  
OLAVO PIRES DE CAMARGO ◽  
...  
Keyword(s):  
Randomized Study ◽  
Control Group ◽  
Study Group ◽  
X Rays ◽  
Long Term Effects ◽  
Level Of Evidence ◽  
Timed Up And Go ◽  
Anthropometric Measures ◽  
One Year

ABSTRACT Objective: To compare the long-term effects of a brace designed to stabilize the patellofemoral (PF) joint in comparison to a standard neoprene sleeve for the knee with patellar hole in patients with patellofemoral osteoarthritis (PFOA). Methods: 38 patients with PFOA and comorbidities received either a functional PF brace (Study Group, SG) or a neoprene sleeve for the knee (Control Group, CG). Both groups received clinical treatment to OA and comorbidities according to a program from the institution. Patients were evaluated with Western Ontario and MacMaster (WOMAC) and Lequesne questionnaires, 30-second chair stand test (30CST), Timed Up and Go (TUG), anthropometric measures and self-reported physical activity in minutes/week at inclusion, one, three and twelve months after placing the brace. X-Rays were taken to measure the angles. Results: At one year there was more abandonment in the CG without differences in weight and body mass index between groups during the study. The SG maintained improvements in Lequesne and WOMAC total and subsets during the year, whereas the CG returned to baseline values for pain, function and total (p < 0.01). TUG and 30CST results were always better in the study group without any clinically important improvement in both groups. Conclusion: Long-term use of functional brace added to self-management program improves pain and function in patients with PFOA. Level of Evidence II, Lesser quality RCT (eg, < 80% followup, no blinding, or improper randomization).

scholarly journals Comparison of Valveplasty and Replacement for Surgical Treatment of Infective Tricuspid Valve Endocarditis

2021 ◽  
Author(s):  
Xie Linfeng ◽  
Chen Xiaodong ◽  
He Jian ◽  
Lin Sixian ◽  
Chen Xingfeng ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Drug Users ◽  
Clinical Effect ◽  
Clinical Results ◽  
Reoperation Rate ◽  
Red Blood Cell Transfusion ◽  
Significant Difference ◽  
Tricuspid Valve Endocarditis

Abstract Background In recent years, due to the increase in intravenous drug injection and intracardiac and vascular interventional treatments among drug users, infective endocarditis involving the right heart of the tricuspid valve has gradually increased.At present, there is no systematic report on surgical treatment of tricuspid infective endocarditis. This paper summarizes the experience of surgical treatment of 56 patients with tricuspid infective endocarditis in our hospital and analyzes its clinical effect. Methods From January 2006 to August 2019, 56 cases of tricuspid infective endocarditis treated by tricuspid valve surgery in our hospital were analyzed retrospectively.including 23 cases of tricuspid valvuloplasty (TVP) and 33 cases of tricuspid valve replacement (TVR). All patients were complicated with tricuspid valve vegetations or moderate and severe tricuspid regurgitation and had surgical indications.The perioperative data were collected and followed up for 6 months to 14 years to summarize and analyze the clinical effect of surgical treatment of tricuspid infective endocarditis. Results Compared with TVR group, the CPB time (79.68 ± 19.02min VS 107.39 ± 25.64min, P < 0.01), ACC time (50.29 ± 16.14min VS 65.52 ± 20.62min, P < 0.01), postoperative mechanical ventilation time (18.65 ± 8.18h VS 44.85 ± 57.68h, P < 0.01) and ICU stay time (38.13 ± 21.80h VS 102.64 ± 142.11h, P = 0.015) in TVP group were shorter. The perioperative red blood cell transfusion (4.87 ± 3.81U VS 7.55 ± 5.42U, P < 0.01) and the incidence of postoperative complications (8.7% VS 33.3%, P < 0.01) were lower.Perioperative death occurred in 1 case in the TVR group, and there was no perioperative death in the TVP group, There was no significant difference between the two groups(3.03% VS 0, P = 0.855). A total of 52 cases were followed up for an average of (5.50 ± 3.79) years.The postoperative 3-year, 5-year and 7-year survival rate were 100%,100%,91.7% in TVP group and 95.2%, 93.8% and 87.5%.The 5-year and 10-year reoperation rate were 0%, 0% in TVP group and 6.7%, 20% in TVR group. Conclusion Surgical treatment of severe tricuspid valve endocarditis has achieved good mid-term clinical results, and the rate of avoiding reoperation is better in TVP group than in TVR group.

scholarly journals Effect of Mobile Internet on Attitude and Self-Efficacy of Patients with Coronary Heart Disease Diagnosed by 12-Lead Holter ECG

2022 ◽  
Vol 2022 ◽  
pp. 1-7
Author(s):  
Haitao Sun ◽  
Jing Li ◽  
Yue Wang ◽  
Xiaoke Ma
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Clinical Data ◽  
Self Efficacy ◽  
Mobile Internet ◽  
Control Group ◽  
Study Group ◽  
Holter Ecg ◽  
Group I ◽  
Group Ii

Objective. To explore the effect of mobile Internet on attitude and self-efficacy of patients with coronary heart disease (CHD) diagnosed by 12-lead Holter ECG. Methods. The clinical data of 62 patients with CHD who underwent routine ECG examination (control group I) and 12-lead dynamic electrocardiogram (control group II) in our hospital (June 2017–December 2020) were retrospectively analyzed, and the clinical data of another 62 patients with CHD who received 12-lead Holter ECG examination combined with mobile Internet in our hospital at the same time (study group) were retrospectively analyzed. The clinical observation indexes of the three groups were compared. Results. No obvious difference in general data among groups ( P > 0.05 ). Compared with the control group I, the positive detection rate (PDR) of the study group and the control group II was obviously higher ( P < 0.05 ), and the PDR of the study group was obviously higher than that of the control group II, without remarkable difference between both groups ( P > 0.05 ). Compared with the control group, the scores of CAS-R of the study group were obviously higher ( P < 0.05 ), and self-efficacy of daily life, health behaviors, medication compliance, and compliance behavior of the study group was obviously better ( P < 0.05 ). The diagnostic efficacy was derived by ROC curve analysis, 12-lead Holter ECG combined with mobile Internet + routine ECG > 12-lead Holter ECG combined with mobile Internet > 12-lead Holter ECG > routine ECG. Conclusion. Compared with the routine ECG, the sensitivity of 12-lead Holter ECG in the diagnosis of CHD is conspicuously higher. Meanwhile, 12-lead Holter ECG combined with mobile Internet can enhance the diagnostic efficiency and improve patients’ perceived control attitude and self-efficacy.

scholarly journals RIGHT SIDED ENDOCARDITIS: CASE SERIES FROM MOROCCO

2021 ◽  
Vol 9 (4) ◽  
pp. 704-714
Author(s):  
A. Laalou ◽  
◽  
A. Chachi ◽  
A. Benbahia ◽  
S. Jourani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Rheumatic Heart Disease ◽  
Pulmonary Valve ◽  
Indwelling Catheters ◽  
Cardiac Devices ◽  
Wide Range ◽  
Rheumatic Heart

Objective: Compared with the extensive data on left sided infective endocarditis, right-sided infective endocarditis (RSIE) remains a rare condition. It accounts for 5–10% of all cases of infective endocarditis (IE) [1] [2] [3].Although it is predominantly encountered in the injecting drug user (IDU) population, where HIV and HCV infections often coexist, rheumatic heart disease remains the most important predisposing factor for IE in our context. The aim our study is to report clinical, investigation, management and outcome data in 5 patients diagnosed with RSIE in our department during the last 2 years. Methods: A retrospective analysis of data of 5 patients with right sided endocarditis in a tertiary care center from 2018 to 2020 was done. Results: All of our patients were young aged females none of them had cardiac devices or history of drug use. Persistent fever was the most common clinical presentation. Interestingly, 4 patients presented clinical heart failure. 3 patients had isolated tricuspid valve IE, one patient had isolated pulmonary valve IE, and one patient have both tricuspid and pulmonary valve IE. Blood cultures were negative in two cases, whilst two others were positive to Streptococcus (alpha) and one positive to Staphylococcus. 4 patients underwent surgical treatment after well conducted antibiotic therapy the indications were the presence of right heart failure secondary to severe tricuspid regurgitation and the size of the vegetations. Unfortunately, one patient died of massive pulmonary embolism despite well conducted antibiotherapy. Conclusion: RSIE is rare and occurs in a wide range of underlying conditions like implantable electronic devices, indwelling catheters, CHD and immune compromised state. Surprisingly, it can occur in young individuals without known risk factors. In our context, rheumatic heart disease remains the most incriminated etiology which lead us to question three essential points: 1. The interest of antibiotic prophylaxis in young patients with VSDs 2. The use of empiric antibiotics with action against streptococcus 3. Early surgical treatment in rheumatic heart disease.

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