Surgery of right-sided endocarditis: valve preservation versus replacement

Area of Science:

• Cardiology
• Cardiac Surgery
• Infectious Diseases

Background:

• Traditional surgical treatment for right-sided endocarditis often involves valve resection or replacement.
• Tricuspid valve involvement in endocarditis presents unique surgical challenges.

Purpose of the Study:

• To evaluate the efficacy and methods of tricuspid valve repair for right-sided endocarditis.
• To define criteria for patient selection and lesion classification for successful tricuspid valve repair.

Main Methods:

• Retrospective analysis of 19 patients undergoing tricuspid valve repair for endocarditis between 1981 and 1989.
• Detailed discussion of valve repair techniques and lesion classification.
• Intraoperative assessment using transesophageal echocardiography and a hand-held color Doppler unit.

Main Results:

• Tricuspid valve repair was successfully performed in 14 out of 19 patients (73.7%).
• The study outlines specific methods for valve repair and classifies lesions amenable to this approach.
• Echocardiographic and Doppler assessments were integral to intraoperative decision-making.

Conclusions:

• Tricuspid valve repair is a viable and successful surgical option for select patients with right-sided endocarditis.
• Careful patient selection based on lesion characteristics and intraoperative assessment are crucial for successful repair.
• Repair strategies can offer an alternative to resection and replacement in managing tricuspid valve endocarditis.