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Contemporary results of mitral valve repair for infective endocarditis

Bernard Iung1, Juliette Rousseau-Paziaud, Bertrand Cormier

  • 1Cardiology Department, Bichat Hospital AP-HP, 46 rue Henri Huchard, 75018 Paris, France. bernard.iung@bch.ap-hop-paris.fr

Journal of the American College of Cardiology
|March 12, 2004
PubMed
Abstract

Insights

Mitral valve repair (MVRep) is feasible for infective endocarditis, offering good long-term survival. While acute endocarditis patients face more follow-up events, both acute and healed cases show excellent late survival rates.

Area of Science:

  • Cardiovascular Surgery
  • Infective Diseases
  • Valvular Heart Disease

Background:

  • Mitral valve repair (MVRep) techniques have advanced, yet its application in endocarditis remains under-explored.
  • Limited data exists on the efficacy of MVRep for both acute and healed infective endocarditis.

Purpose of the Study:

  • To assess the feasibility of mitral valve repair (MVRep) in patients with infective endocarditis.
  • To evaluate the immediate and long-term outcomes of MVRep for acute and healed endocarditis.

Main Methods:

  • Retrospective analysis of 78 patients with mitral endocarditis (1990-1999).
  • 63 patients underwent mitral valve repair (MVRep), with 25 for acute and 38 for healed endocarditis.
  • Detailed analysis of repair techniques, early complications, and long-term event-free survival.

Main Results:

  • Mitral valve repair (MVRep) was feasible in 81% of patients, utilizing various techniques including annuloplasty, valve resection, and chordal repair.
  • Early complications included a 3.2% mortality rate and re-operations for mitral regurgitation and aortic endocarditis.
  • Seven-year event-free survival was 78%; hypertension and acute endocarditis were predictors of adverse events.

Conclusions:

  • Mitral valve repair (MVRep) is a feasible and effective treatment for infective endocarditis.
  • Patients with acute endocarditis experienced more follow-up events but demonstrated excellent long-term survival.
  • MVRep offers good results and excellent late survival for both acute and healed endocarditis.

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