Early And Long Term Outcomes Of Mitral Valve Plasty For Active Mitral Valve Infective Endocarditis
Chiho Tokunaga, Hiroyuki Nakajima, Yu Kumagai, Yuto Hori, Fumiya Chubachi, Satoru Murata, Akitoshi Takazawa, Tomomi Nakajima, Masatoshi Akiyama, Toshihisa Asakura, Akihiro Yoshitake.
Saitama medical university, international medical center, Hidaka, Japan.
Mitral valve regurgitation (MR) due to infective endocarditis (IE) remains life threatening diseases and traditionally treated by prosthetic valve replacement rather than mitral valve repair (MVP). Although, MVP has become a gold standard treatment for MR in the last decade and indication of MVP for IE is also extending. The object of this study is to evaluate the early and long-term outcomes of MVP for active mitral valve IE.
Between 2007 and 2021, 119 consecutive patients were treated for native mitral valve active IE in our institute. Of these, 30 patients who underwent MVP were reviewed retrospectively.
The mean age was 54.7 ± 15.8 years. Preoperative WBC and CRP was 7784 ± 3856 /u and 3.0 ± 3.4 mg/dl, respectively. The mean follow up period was 57.1 ± 46.7months (1-136 months). Mean duration of preoperative antibiotics use was 35.5 ± 22.8 days. Repair techniques include 20 ring annuloplasty and 8 partial annuloplasty with CV-5. In addition, 17 resection and suture, 8 patch plasty, 6 edge to edge, 2 chordal replacement and 1 Alfieri stitch was performed. Early mitral valve replacement for recurrent MR was required in 1 patients, while MR was controlled less than mild in other 29 patient. Late re-operation due to recurrent MR was not observed in this study. In hospital mortality was 3.3% in 1 patient due to intracranial hemorrhage. Long-term survival was 6.6% in 2 patients. The overall survival rate at 1, 5 and 10 years was 92.9%, 87.5% and 87.5%, respectively.
CONCLUSIONS: MVP for IE demonstrates feasible early and long-term outcomes. While MVP is considered to be a challenging technique for IE, it is safely performed with low postoperative mortality in selected patients with appropriate repair technique.
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