|Tailored surgical therapy for acute native mitral valve endocarditis.|
|PMID: 15086259 Owner: NLM Status: MEDLINE|
|BACKGROUND AND AIM OF THE STUDY: Mitral valve repair has been shown superior to valve replacement for the treatment of non-infectious valve disease. The criteria and results of valve repair for native valve endocarditis are still being defined. The study aim was to examine the short- and long-term results of mitral valve repair and replacement for acute infective endocarditis and to define criteria for the use of each technique. METHODS: A total of 53 consecutive patients who presented with acute native mitral valve infective endocarditis (diagnosed less than six weeks before surgery) between January 1992 and June 2002 was retrospectively analyzed. RESULTS: Twenty-one patients (40%) underwent mitral valve repair, and 32 (60%) underwent valve replacement. Operative mortality was 0% for the repair group and 13% (4/32) for the replacement group (p = 0.14). Median follow up was 4 years (range: 6-108 months). At five years follow up, a median ejection fraction (EF) of 60% and mitral regurgitation (MR) grade of 1/4 was observed, with an overall late survival of 85% (19/21), in the repair group, while the replacement group had a median EF of 55% and an overall late survival of 73% (p = 0.73). Recurrent endocarditis occurred in 2/21 (10%) in the repair group and 1/32 (3%) in the replacement group (p = 0.34). CONCLUSION: Mitral valve repair is a safe and effective technique to treat acute native mitral valve infective endocarditis with favorable short- and long-term morbidity and mortality. Patients with advanced endocarditis and annular destruction require valve replacement. Mitral valve repair should be performed when technically feasible.|
|Tomislav Mihaljevic; Subroto Paul; Marzia Leacche; James D Rawn; Sary Aranki; Patrick T O'Gara; Lawrence H Cohn; John G Byrne|
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|Type: Comparative Study; Journal Article|
|Title: The Journal of heart valve disease Volume: 13 ISSN: 0966-8519 ISO Abbreviation: J. Heart Valve Dis. Publication Date: 2004 Mar|
|Created Date: 2004-04-16 Completed Date: 2004-11-06 Revised Date: 2007-11-15|
Medline Journal Info:
|Nlm Unique ID: 9312096 Medline TA: J Heart Valve Dis Country: England|
|Languages: eng Pagination: 210-6 Citation Subset: IM|
|Division of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.|
|APA/MLA Format Download EndNote Download BibTex|
Aged, 80 and over
Endocarditis, Bacterial / microbiology*, mortality, surgery*
Heart Valve Diseases / microbiology*, mortality, surgery*
Heart Valve Prosthesis Implantation* / mortality
Mitral Valve / microbiology*, surgery*, ultrasonography
Postoperative Complications / etiology, mortality, physiopathology
Staphylococcal Infections / microbiology*, mortality, surgery*
Statistics as Topic
Streptococcal Infections / microbiology*, mortality, surgery*
Stroke Volume / physiology
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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