PubMed · 14922382
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S AARSETH. 1951-11-15. [Bacterial endocarditis].. https://pubmed.ncbi.nlm.nih.gov/14922382/
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OBJECTIVE: To attempt to reconcile reports containing contradictory findings with the St. Jude Medical Silzone heart valve. METHODS: Major leak and thromboembolism data were extracted from available Silzone valve studies. Linearized rates were used to summarize and compare the events rates among the studies. RESULTS: The Artificial Valve Endocarditis Reduction Trial (AVERT) study reported significant higher rate of major leak and the Cardiff Embolic Risk Factor Study (CERFS) reported significant higher rate of thromboembolism with Silzone compared to non-Silzone valves. But, current updates of these studies show a diminution of these differences. Three other comparative studies reported no difference between Silzone and non-Silzone valves, and three single arm studies reported acceptable results with Silzone valves. CONCLUSION: The contradictory findings could be partly due to clinical and technical reasons. No new events have been reported since the original AVERT (major leak) and CERFS (mitral thromboembolism) publications.
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Cardiac involvement in Whipple's discase is frequent. However, its clinical occurrence without gastrointestinal symptoms is rarely described. Whipple's endocarditis occurs ollen in patients wilh native valves, without underlying, disease. It affects frequently more than one valve h, the same patient. Its clhlical presentation is generally subacute or chronic. Fever and congestive heart failure are fickle. Histological findings on the valves suggest the diagnosis, that con be confirmed by PCR technique. Treatment must be prolonged. We report a case of Whipple's endocarditis revealed by arterial embolisms and fever appeured 3 weeks after the onset.