Endoscopic port access surgery for isolated atrioventricular valve endocarditis

Area of Science:

• Cardiovascular Surgery
• Infectious Diseases
• Minimally Invasive Procedures

Background:

• Atrioventricular valve endocarditis (AVVE) poses significant surgical challenges.
• Minimally invasive cardiac surgery techniques are increasingly explored for complex valve pathologies.
• Endoscopic approaches offer potential advantages in reducing surgical trauma.

Purpose of the Study:

• To evaluate the clinical and echocardiographic outcomes of endoscopic port access surgery for isolated active and convalescent atrioventricular valve endocarditis (AVVE).
• To assess the safety and efficacy of a minimally invasive approach for AVVE treatment.

Main Methods:

• Retrospective analysis of 66 consecutive patients undergoing endoscopic port access surgery for isolated AVVE between May 2004 and July 2015.
• Data collected included patient demographics, EuroSCORE II, procedure details, cardiopulmonary bypass and ischemic times, in-hospital morbidities, and survival rates.
• Kaplan-Meier analyses were used to determine long-term survival and freedom from reintervention.

Main Results:

• The study included 66 patients with isolated AVVE, with a mean age of 65.5 years and a mean EuroSCORE II of 31.2%.
• 30-day survival rate was 87.9%. Long-term survival at 10 years was 69.4%, with 98.4% freedom from AVVE reintervention.
• Mid-term survivors (93.9%) showed good functional status (NYHA II or less) and minimal mitral regurgitation.

Conclusions:

• Endoscopic port access surgery is a viable and effective treatment option for selected patients with atrioventricular valve endocarditis (AVVE).
• Experienced centers can successfully perform complex AVVE surgery using minimally invasive techniques.
• Surgeons should consider endoscopic approaches to offer patients the benefits of minimally invasive cardiac surgery for AVVE.