Skip to main content
SpringerLink
Log in

Mitral valve repair for infective endocarditis

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objective

This study investigated the feasibility of mitral valve (MV) repair in patients with active or healed infective endocarditis (IE) with mitral regurgitation and evaluated effects on left ventricular (LV) function and structure.

Methods

Subjects comprised 19 patients who underwent MV operations for IE between December 2004 and September 2007. MV repair was performed for acute IE in 10 of 15 patients (67%) and for healed IE in 4 of 4 patients (100%).

Results

No early or late postoperative deaths were encountered. One patient underwent redo MV repair owing to severe mitral regurgitation 1 month postoperatively. Postoperative echocardiography after MV repair demonstrated less than trivial (acute IE in seven, healed IE in three) or mild (acute IE in three, healed IE in one) mitral regurgitation. In patients with MV replacement, the postoperative left atrial dimension (LAD) was decreased (51.5 ± 39.2 vs. 39.2 ± 1.9 mm, P = 0.007); however LV end-diastolic dimension (LVDD) and LV end-systolic dimension were unchanged. In patients with MV repair, LVDD (57.5 ± 6.5 vs. 46.0 ± 5.6 mm, P < 0.001), LV end-systolic dimension (36.1 ± 5.2 vs. 32.4 ± 6.2 mm, P = 0.04), LAD (43.1 ± 8.1 vs. 33.6 ± 7.7 mm, P = 0.003) were reduced. Postoperative ejection fraction (55.3 ± 13.5% vs. 41.8% ± 10.0%, P = 0.03) and fraction shortening (30.1% ± 9.2% vs. 20.7% ± 5.5%, P = 0.03) were better in patients with MV repair than those with MV replacement.

Conclusions

MV repair is feasible in patients with both active and healed IE. MV repair preserves better LV function and structure postoperatively.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gillinov AM, Cosgrove DM, Blackstone EH, Diaz R, Arnold JH, Lytle BW, et al. Durability of mitral valve repair for degenerative disease. J Thorac Cardiovasc Surg 1998;116:734–743.

    Article  PubMed  CAS  Google Scholar 

  2. Yun KL, Fann JI, Rayhill SC, Nasserbakht F, Derby GC, Handen CE, et al. Importance of the mitral subvalvular apparatus for left ventricular segmental systolic mechanics. Circulation. 1990;82(suppl IV):IV-89–IV-104.

    CAS  Google Scholar 

  3. Dreyfus G, Serraf A, Jebara VA, Deloche A, Chauvaud S, Couetil JP, et al. Valve repair in acute endocarditis. Ann Thorac Surg 1990;49:706–713.

    PubMed  CAS  Google Scholar 

  4. Muerhrcke DD, Cosgrove DM 3rd, Lytle BW, Taylor PC, Burgar AM, Durnwald CP, et al. Is there an advantage to repairing infected mitral valves? Ann Thorac Surg 1997;63:1718–1724.

    Article  Google Scholar 

  5. Sternik L, Sehr KJ, Orszulak TA, Mullany CJ, Daly RC, Schaff HV. The advantage of repair of mitral valve in acute endocarditis. J Heart Valve Dis 2002;11:91–98.

    PubMed  Google Scholar 

  6. Kasegawa H, Kamata S, Ida T, Kawase M, Fujimoto T, Umezu M. Physiologic remodeling annuloplasty to retain the shape of the anterior leaflet: a new concept in mitral valve repair. J Heart Valve Dis 1997;6:604–607.

    PubMed  CAS  Google Scholar 

  7. Durak DT, Lukes AS, Bright DK. New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Dukes Endocarditis Service. Am J Med 1994;96:200–209.

    Article  Google Scholar 

  8. Mugge A, Daniel WG, Frank G, Lichtlen PR. Echocardiography in infective endocarditis reassessment of prognostic implications of vegetation size determined by the transthoracic and the transecophageal approach. J Am Coll Cardiol 1989;14:631–638.

    Article  PubMed  CAS  Google Scholar 

  9. Gammie JS, O’Brien SM, Griffith BP, Peterson ED. Surgical treatment of mitral valve endocarditis in north America. Ann Thorac Surg 2005;80:2199–2204.

    Article  PubMed  Google Scholar 

  10. Eishi K. Notes to avoid failure in mitral valvluoplasty. Ann Thorac Cardiovasc Surg 2001;7:69–74.

    PubMed  CAS  Google Scholar 

  11. Shrestha B, Ishizuka N, Tanimoto K, Kawai A, Kurosawa H, Kasanuki H. Echocardiography 2004;21:531–536.

    Article  PubMed  Google Scholar 

  12. Livesey SA. Mitral valve reconstruction in the presence of infection. Heart 2006;92:289–290.

    Article  PubMed  CAS  Google Scholar 

  13. Manhas DR, Mohri H, Hessel EA, Merendino KA. Experience with surgical management of primary infective endocarditis: a collected review of 139 patients. Am Heart J 1972;84:738–747.

    Article  PubMed  CAS  Google Scholar 

  14. Bonow RO, Carabello B, de Leon AC Jr, Edmunds LH Jr, Fedderly BJ, Freed MD, et al. ACC/AHA guidelines for the management of patients with valvular heart disease: a report of the American Colledge of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 1998;32:2936–2948.

    Article  Google Scholar 

  15. Frater RWM. Editorial comment: 10th Gore-Tex chordia anniversary. J Heart Valve Dis 1996;5:348–351.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Surgery, Showa University Hospital, Hatanodai 1-5-8, Shinagawa-ku, Tokyo, 142-8555, Japan

    Tadashi Omoto, Masahiro Ohno, Masaomi Fukuzumi, Masaya Ohi, Takahisa Okayama, Noboru Ishikawa & Takeo Tedoriya

  2. Hanzomon Cardiovascular Clinic, Tokyo, Japan

    Hitoshi Kasegawa

Authors
  1. Tadashi Omoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masahiro Ohno
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masaomi Fukuzumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masaya Ohi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takahisa Okayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Noboru Ishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hitoshi Kasegawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takeo Tedoriya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tadashi Omoto.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Omoto, T., Ohno, M., Fukuzumi, M. et al. Mitral valve repair for infective endocarditis. Gen Thorac Cardiovasc Surg 56, 277–280 (2008). https://doi.org/10.1007/s11748-007-0209-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-007-0209-4

Key words

Search

Navigation