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The advantage of repair of mitral valve in acute endocarditis

Leonid Sternik1, Kenton J Zehr, Thomas A Orszulak

  • 1Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55902, USA.

The Journal of Heart Valve Disease
|February 15, 2002
PubMed
Abstract

Insights

Mitral valve repair is superior to replacement for active endocarditis, showing better survival and fewer complications. Repair offers a significant advantage for patients with this condition.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Valvular Heart Disease

Background:

  • Mitral valve repair offers survival benefits for non-infectious mitral regurgitation.
  • The advantage of mitral valve repair over replacement in active endocarditis remains unclear.
  • This study compares morbidity, mortality, and event-free survival between repair and replacement for endocarditis.

Purpose of the Study:

  • To compare outcomes of mitral valve repair versus replacement in patients with active endocarditis.
  • To determine if mitral valve repair offers an advantage in terms of survival and complications.
  • To identify risk factors for mortality in patients undergoing mitral valve surgery for endocarditis.

Main Methods:

  • A retrospective study of 44 patients with acute native mitral valve endocarditis from 1986 to 1999.
  • Patients underwent either mitral valve replacement (28) or repair (16).
  • Repairs included simple and complex techniques, with detailed follow-up data.

Main Results:

  • No early or late deaths occurred in the repair group, versus 21% in-hospital and 21% late deaths in the replacement group (p <0.05).
  • Mitral valve replacement and need for associated procedures were independent risk factors for death.
  • Five patients needing replacement required reoperation for recurrent endocarditis; none in the repair group (p=0.065).

Conclusions:

  • Mitral valve repair is associated with better early and late mortality and event-free survival compared to replacement in acute endocarditis.
  • Valve repair should be prioritized for patients with active endocarditis whenever feasible.
  • Repair may reduce the need for reoperation in this patient population.

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