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Long-Term Outcomes of Mitral Valve Repair for Active Endocarditis
Hideo Kanemitsu1, Ken Nakamura, Naoto Fukunaga
1Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital.
Background:
The long-term outcomes of mitral valve (MV) repair for active infective endocarditis (AE) are not well known, so the present study examined results from >5 years.
Methods And Results:
We retrospectively reviewed 43 patients who underwent primary MV repair for AE at a single center between 1991 and 2009. Patients' mean age was 50.9 years, and 39% were female. The mean follow-up was 7.4 years, and 90.7% of the patients had serial echocardiographic studies over the years. We examined the data for mortality, mitral reoperation, and recurrent significant mitral regurgitation (MR). There were no early deaths but 6 late deaths. Survival was 92.6±4.1% for 5 years, and 83.5±7.3% for 10 years. The respective 5- and 10-year rates of freedom from MV reoperation were 90.5±4.5% and 86.6±5.8%, and for freedom from moderate or severe MR were 95.0±3.5 and 86.1±6.7%. Recurrence of endocarditis was observed in 2 patients (4.7%). Most (86%) of the survivors were in New York Heart Association class I.
Conclusions:
MV repair for AE is durable and offers acceptable long-term outcomes with low rates of recurrence and reoperation. (Circ J 2016; 80: 1148-1152).
Insights
Mitral valve (MV) repair for active infective endocarditis (AE) shows durable, long-term success. This study found acceptable outcomes with low rates of mitral reoperation and recurrent mitral regurgitation.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Valvular Heart Disease
Background:
- Long-term outcomes of mitral valve (MV) repair for active infective endocarditis (AE) remain largely unknown.
- This study retrospectively analyzed outcomes of primary MV repair for AE.
Purpose of the Study:
- To evaluate the long-term durability and efficacy of mitral valve repair in patients with active infective endocarditis.
- To assess rates of mortality, reoperation, and recurrent mitral regurgitation after MV repair for AE.
Main Methods:
- Retrospective review of 43 patients undergoing primary MV repair for AE between 1991 and 2009.
- Mean follow-up of 7.4 years with serial echocardiographic assessments.
- Analysis focused on mortality, mitral reoperation, and recurrent significant mitral regurgitation (MR).
Main Results:
- Survival rates were 92.6% at 5 years and 83.5% at 10 years.
- Freedom from MV reoperation was 90.5% at 5 years and 86.6% at 10 years.
- Freedom from moderate/severe MR was 95.0% at 5 years and 86.1% at 10 years; 4.7% experienced endocarditis recurrence.
Conclusions:
- Mitral valve repair for active infective endocarditis is a durable procedure.
- Acceptable long-term outcomes are achievable with low rates of recurrence and reoperation.
- Most survivors achieved excellent functional status (NYHA class I).
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