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Significance of mitral valve repair for active-phase infective endocarditis

Tadashi Omoto1, Takeo Tedoriya, Masaya Oi

  • 1Department of Surgery, Division of Thoracic and Cardiovascular Surgery, Showa University, Hatanodai 1-5-8, Shinagawa-ku, Tokyo, Japan. tomoto@med.showa-u.ac.jp

Asian Cardiovascular & Thoracic Annals
|April 8, 2011
PubMed

Insights

Mitral valve repair is feasible during active infective endocarditis, offering better left ventricular function post-surgery. However, complex repairs may lack long-term durability.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Cardiac Pathology

Background:

  • Mitral valve repair is generally preferred over replacement in infective endocarditis.
  • Active-phase endocarditis necessitates extensive debridement and complex reconstruction for mitral valve repair.

Purpose of the Study:

  • To investigate the feasibility and outcomes of mitral valve repair during the active phase of infective endocarditis.
  • To compare the postoperative left ventricular dimensions and function between mitral valve repair and replacement in active infective endocarditis.

Main Methods:

  • Retrospective analysis of 22 consecutive native mitral valve operations during active-phase infective endocarditis.
  • Mitral valve repair techniques included prosthetic annuloplasty, autologous pericardial patch, and artificial chordal replacement.
  • Comparison of postoperative left ventricular end-diastolic dimension and ejection fraction between repair and replacement groups.

Main Results:

  • Mitral valve repair was performed in 15 patients (68.2%).
  • Hospital mortality was 9.1%.
  • Valve repair patients showed significantly smaller left ventricular end-diastolic dimensions and higher ejection fractions postoperatively compared to valve replacement patients. Three patients required reoperation for mitral regurgitation.

Conclusions:

  • Mitral valve repair is a feasible option in active infective endocarditis, leading to improved left ventricular remodeling.
  • Complex mitral valve repair strategies, particularly those involving extensive leaflet resection, may compromise long-term durability.

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