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Mitral valve repair for infective endocarditis: Kobe experience
Yukikatsu Okada1, Takeo Nakai1, Takashi Muro1
1Heart Valve Center, Midori Hospital, Kobe, Japan.
Asian Cardiovascular & Thoracic Annals
|August 8, 2020
Summary
Mitral valve repair for infective endocarditis demonstrated high success rates, with excellent long-term survival and freedom from reoperation. This procedure is recommended for most patients with mitral valve endocarditis.
Area of Science:
- Cardiovascular Surgery
- Infective Diseases
- Valvular Heart Disease
Background:
- Native mitral valve endocarditis poses significant risks, often necessitating surgical intervention.
- Mitral valve repair aims to preserve native valve function and improve patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and long-term results of mitral valve repair in patients with native mitral valve endocarditis.
- To assess overall survival, freedom from reoperation, and freedom from valve-related events after mitral valve repair.
Main Methods:
- Retrospective analysis of 147 patients undergoing mitral valve repair for infective endocarditis between 1991 and 2011.
- Patients were categorized into healed (Group A) and active (Group B) infective endocarditis groups.
- Repair techniques included infected tissue resection, leaflet/annulus reconstruction with autologous pericardium, chordal repair with polytetrafluoroethylene sutures, and annuloplasty.
Main Results:
- Hospital mortality was low (0.7%). Ten-year survival was 88.5% ± 3.5%.
- Freedom from reoperation at 5 years was significantly higher in Group A (99% ± 1.0%) compared to Group B (89.6% ± 4.0%, p=0.024).
- Ten-year event-free survival was 79.3% ± 4.8%, with better outcomes in Group A (83.4% ± 5.9%) versus Group B (72.6% ± 6.9%, p=0.010).
Conclusions:
- Mitral valve repair using autologous pericardium, chordal reconstruction, and annuloplasty is highly successful for native mitral valve endocarditis.
- Acceptable long-term outcomes regarding survival, reoperation, and valve-related events support the efficacy of this approach.
- Mitral valve repair is a recommended treatment option for the majority of patients presenting with mitral infective endocarditis.
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