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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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[Surgical treatment of mitral valve endocarditis]

Yukikatsu Okada1

  • 1Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.

Nihon Geka Gakkai Zasshi
|February 21, 2009
PubMed

Insights

Mitral valve repair is a preferred treatment for mitral regurgitation, even with infective endocarditis. This study shows durable, excellent long-term results and survival rates for patients undergoing complex mitral valve repair.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Biomaterials Science

Context:

  • Mitral valve regurgitation (MVR) necessitates timely intervention for optimal patient outcomes.
  • Infective endocarditis (IE) poses unique challenges to mitral valve integrity and surgical repair.
  • Mitral valve repair (MVR) is increasingly favored over replacement for MVR due to better preservation of left ventricular function.

Purpose:

  • To evaluate the long-term efficacy and safety of mitral valve repair in patients with active or healed infective endocarditis.
  • To assess the feasibility and outcomes of complex mitral valve repair techniques using autologous pericardium and expanded polytetrafluoroethylene (ePTFE).

Summary:

  • A review of 120 patients (72 men, 48 women; mean age 48 years) undergoing mitral valve repair for IE between 1991 and 2008.
  • Repair techniques included patch grafting with autologous pericardium and chordal reconstruction with ePTFE, often combined with a prosthetic ring.
  • The 10-year survival rate was 92% and freedom from reoperation was 96%, demonstrating the durability and success of these repair methods.

Impact:

  • Mitral valve repair for IE can be achieved with low operative mortality and excellent long-term results.
  • Advanced repair techniques using pericardium and ePTFE expand the applicability of mitral valve repair in complex IE cases.
  • This approach offers a durable solution, improving event-free survival and preserving left ventricular function in patients with IE-related mitral valve disease.

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