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Surgery for Active Infective Endocarditis on Mitral Valve: Anatomical, Surgical, and Disease Factors as Long-Term
Paolo Berretta1, Olimpia Bifulco1,2, Suvitesh Luthra3
1Cardiac Surgery Unit, Lancisi Cardiovascular Center, Ospedali Riuniti delle Marche, Polytechnic University of Marche, 60126 Ancona, Italy.
Medicina (Kaunas, Lithuania)
|June 27, 2024
Summary
Long-term survival after mitral valve surgery for endocarditis is impacted by Staphylococcus aureus infection and patient comorbidities. Mitral valve repair versus replacement did not significantly affect long-term outcomes or reoperation rates.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Cardiac Surgery Outcomes
Background:
- Long-term outcomes following surgery for native mitral valve endocarditis require further investigation.
- Understanding risk factors for mortality and reintervention is crucial for patient management.
Purpose of the Study:
- To assess anatomical, disease, and surgical risk factors for long-term mortality.
- To evaluate factors influencing the need for mitral reoperation after endocarditis surgery.
Main Methods:
- Analysis of 335 patients undergoing surgery for active native mitral valve endocarditis (2000-2022).
- Kaplan-Meier survival analysis and multivariable Cox regression.
- Primary outcome: long-term survival; Secondary outcome: freedom from mitral reoperation.
Main Results:
- 5- and 10-year survival rates were 70.1% and 59.2%, respectively.
- Staphylococcus aureus infection independently predicted late mortality, alongside age, COPD, and prior cardiac surgery.
- Valve repair versus replacement did not impact long-term mortality or reoperation rates; 5- and 10-year freedom from reoperation was 94.7% and 91.8%.
Conclusions:
- Active mitral valve endocarditis significantly impairs long-term survival.
- Infecting pathogens (e.g., S. aureus) and patient comorbidities are key determinants of long-term outcomes.
- Surgical approach (repair vs. replacement) did not influence long-term survival or reoperation necessity.
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