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Updated: Aug 5, 2026
08:12
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Longitudinal Outcomes of Mitral Valve Surgery for Infective Endocarditis Within a Repair-First Strategy
Hakam Rajjoub1, Stanley B Wolfe1, Lawrence Wei1
1Department of Cardiovascular and Thoracic Surgery, West Virginia University.
The Annals of Thoracic Surgery
|July 30, 2026
Summary
Mitral valve repair in infective endocarditis offers better survival and fewer complications than replacement. A repair-first strategy is safe and effective for improving patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Infective Endocarditis
- Mitral Valve Disease
Background:
- Mitral valve (MV) infective endocarditis (IE) often requires surgery for severe mitral regurgitation.
- The long-term effects of MV surgery using a repair-first approach are not well understood.
Purpose of the Study:
- To evaluate the outcomes of mitral valve surgery in patients with acute infective endocarditis.
- To compare the results of mitral valve repair versus replacement within a repair-first strategy.
Main Methods:
- A retrospective analysis of 198 patients undergoing MV surgery for IE between 2016 and 2024.
- Patients were managed with a repair-first strategy; replacement was used when repair was not feasible.
- Primary outcomes included survival and a composite of reinfection, reoperation, or death.
Main Results:
- 102 patients (51.5%) underwent repair and 96 (48.5%) underwent replacement.
- The repair group had significantly better survival (HR 0.49, p=0.01) and freedom from composite outcomes (HR 0.27, p<0.0001).
- Repair was associated with shorter ICU stays and less prolonged ventilation.
Conclusions:
- Complex mitral valve repair in acute IE is safe and durable.
- A repair-first strategy leads to favorable perioperative recovery and improved mid-term outcomes.
- These findings support a repair-first approach for MV intervention in IE when feasible.
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