Document Detail


Contemporary results of mitral valve repair for infective endocarditis.
MedLine Citation:
PMID:  15013119     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to evaluate the feasibility and immediate and late results of mitral valve repair (MVRep) for acute and healed endocarditis. BACKGROUND: Improvements in techniques of MVRep have extended its feasibility in complex lesions, but experience with endocarditis is limited. METHODS: Among 78 patients operated on for mitral endocarditis between 1990 and 1999, 63 underwent MVRep. The repair was performed for acute endocarditis in 25 patients (40%) at a median of 20 days after the onset of treatment and in 38 patients (60%) for healed endocarditis after a median of 11 months. RESULTS: Repair of the mitral valve was feasible in 63 patients (81%). This repair involved annuloplasty in 61 patients (97%), valve resection in 49 (78%), shortening or transposition of chordae in 29 (46%), suture of perforation in 18 (29%), a pericardial patch in 12 (19%), and a partial mitral homograft in 7 (11%). Associated procedures were aortic valve replacement in 11 patients, bypass grafting in 3, and tricuspid repair in 2. Early complications were two deaths (3.2%), one re-operation for severe mitral regurgitation and one re-operation for subsequent aortic endocarditis. The seven-year rate of event-free survival was 78 +/- 6% in the global series. Multivariate predictors of event-free survival were hypertension (p < 0.006) and intervention for acute endocarditis (p < 0.026). Five-year survival rates were 96 +/- 4% after MVRep for acute endocarditis and 91 +/- 5% for healed endocarditis. CONCLUSIONS: Mitral valve repair is frequently feasible and gives good results in patients with infective endocarditis. Patients operated on for acute endocarditis experience more events during follow-up than those operated on after healed endocarditis but have excellent late survival.
Authors:
Bernard Iung; Juliette Rousseau-Paziaud; Bertrand Cormier; Eric Garbarz; Olivier Fondard; Eric Brochet; Christophe Acar; Jean-Paul Couëtil; Ulrik Hvass; Alec Vahanian
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  43     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-03-11     Completed Date:  2004-04-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  386-92     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Department, Bichat Hospital AP-HP, 46 rue Henri Huchard, 75018 Paris, France. bernard.iung@bch.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Cardiac Surgical Procedures / methods*
Endocarditis, Bacterial / microbiology,  surgery*
Feasibility Studies
Female
Humans
Male
Middle Aged
Mitral Valve / surgery*
Staphylococcal Infections / complications
Streptococcal Infections / complications
Treatment Outcome
Wound Healing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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