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Mitral valve repair for infective endocarditis

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.

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Correspondence to Tadashi Omoto.

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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

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Key words

  • Mitral valve repair
  • Infective endocarditis