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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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Repair of Isolated Native Mitral Valve Endocarditis: A Propensity Matched Study
Mark R Helmers1, Cody Fowler1, Samuel T Kim1
1Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
Seminars in Thoracic and Cardiovascular Surgery
|July 1, 2021
Summary
Mitral valve repair is safe and effective for endocarditis, offering faster recovery and fewer repeat interventions compared to replacement. This "repair if feasible" approach is recommended for isolated native valve endocarditis.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Medical Devices
Background:
- Mitral valve repair is superior to replacement for chronic mitral regurgitation.
- Limited data exists comparing mitral valve repair and replacement for endocarditis.
Purpose of the Study:
- To compare outcomes of mitral valve repair versus replacement in patients with endocarditis.
- To determine if mitral valve repair offers advantages in the endocarditis population.
Main Methods:
- Retrospective review of 267 isolated mitral valve surgeries for endocarditis (1998-2019).
- Propensity score matching to compare mitral valve repair (124 patients) versus replacement (153 patients).
Main Results:
- Repair group showed shorter ventilator, ICU, and hospital stays (p<0.05).
- Similar 30-day mortality (0% vs 2.1%) and 10-year survival (88% vs 86%) between groups.
- Repair group had significantly lower rates of repeat mitral valve intervention for recurrent endocarditis (0% vs 10.6%, p=0.03).
Conclusions:
- Mitral valve repair is a safe and feasible option for isolated native valve endocarditis.
- Repair is associated with faster patient recovery and reduced need for reintervention.
- A
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