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Clinical course after surgical treatment of active isolated native mitral valve endocarditis

M Wilbring1, K Alexiou, M Tuan Nguyen

  • 1Department of Cardiac Surgery, University Heart Center, Dresden, Germany - manuel.wilbring@gmail.com.

The Journal of Cardiovascular Surgery
|October 18, 2013
PubMed
Abstract

Insights

Isolated mitral valve endocarditis (MVE) patients often face surgical delays and present with severe sepsis. Cardiac surgery offers good results, but long-term survival depends on managing extracardiac conditions.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Isolated mitral valve endocarditis (MVE) is a distinct subgroup of native infective valve endocarditis (NVE).
  • Characterizing MVE and analyzing surgical outcomes is crucial for improving patient management.

Purpose of the Study:

  • To characterize isolated mitral valve endocarditis (MVE).
  • To analyze the clinical course and outcomes of patients with MVE undergoing cardiac surgery.

Main Methods:

  • Retrospective analysis of 474 patients with NVE from 1997-2011.
  • Identified 89 patients (18.8%) with MVE, analyzing demographics, comorbidities, surgical procedures, and outcomes.
  • Follow-up data comprised 267 patient-years.

Main Results:

  • A significant delay (4.7±1.2 weeks) between symptom onset and surgery was observed, with many patients critically ill.
  • MVE patients had higher rates of stroke, atrial fibrillation, CAD, and COPD; Staphylococcus aureus was the predominant pathogen.
  • Early mortality (6.7%) was linked to sepsis; prolonged ICU stay and ventilation increased in-hospital death risk. Five-year survival was 59.6%, impacted by extracardiac comorbidities.

Conclusions:

  • Isolated MVE presents unique challenges including delayed diagnosis, specific microbiological profiles, and increased stroke prevalence.
  • Cardiac surgery for MVE can achieve favorable clinical results.
  • Mid-term survival is significantly influenced by the presence of extracardiac comorbidities.

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