[Mitral reconstruction in patients with infective endocarditis]

Area of Science:

• Cardiovascular Surgery
• Infectious Diseases
• Cardiac Valve Disease

Background:

• Infective endocarditis can cause significant damage to native heart valves, particularly the mitral valve.
• Surgical intervention is often necessary for patients with hemodynamic compromise or persistent infection.
• Mitral valve repair versus replacement is a critical decision in managing infective endocarditis.

Purpose of the Study:

• To evaluate the efficacy and outcomes of mitral valve repair in patients with infective endocarditis.
• To assess the long-term results and quality of life following mitral valve repair for native valve endocarditis.

Main Methods:

• Retrospective analysis of 5 male patients (age 51-64) with native mitral valve infective endocarditis undergoing open heart surgery.
• Surgical technique involved V-shaped resection of affected leaflets, valve reconstruction with suturing, and Teflon-tape annuloplasty.
• Patients were selected based on hemodynamic status, echocardiographic findings, and resolution of active infection prior to surgery.

Main Results:

• All 5 patients demonstrated dramatic postoperative hemodynamic improvement.
• No recurrence of endocarditis was observed during 22-38 months of follow-up.
• Patients undergoing repair did not require long-term anticoagulation with Warfarin.

Conclusions:

• Mitral valve repair is an acceptable and effective surgical option for select patients with infective endocarditis.
• Repair offers a better quality of life than replacement when infectious lesions are confined to leaflets/chordae, without severe calcification, and after infection resolution.
• Successful mitral valve repair in infective endocarditis avoids the need for anticoagulation and associated complications.