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DOI: 10.1055/s-2008-1038032
Mitral valve repair in patients with acute native valve endocarditis: Encouraging results in a highly selected patient group
Objectives: Mitral valve repair in patients with acute endocarditis is still controversially discussed, although improvements in techniques of MVRep have extended its feasibility in complex lesions, but experience in acute endocarditis is limited. In this report we aim to evaluate the durability of complex repairs.
Methods: Between May 2000 and June 2007, 16 patients with acute native MV endocarditis underwent MVRep. The patients had complex repairs. Concomitant CABG was performed in 3 patients, AVReconstruction in 3 patients, AVR in 2 patients, ASD closure in 1 patient. Mean age was 62.5 years, 10 were male. 3 patients were reoperated (2 after CABG, 1 after MVRep). Preop. NYHA functional class was 2.8.
Results: 15 of 16 patients could be followed-up. Follow-up was max. 78 months (mean 21 mo.). 30-days mortality was 19% (3 patients, 2., 4., 25. po. day, all by multiorgan failure with a well functioning repaired MV in TEE). 7 patients (44%) died during the follow-up period (1 pt. 33. po. day, 6 pts. 17–78 months po., all non cardiac related deaths). 2 pts. required MV-replacement caused by insufficient leaflet-coaptation, but no recurrent infection at the time of redo (both 3 weeks after repair). The stability of the repair could be proven in the remaining pts. by echocardiography.
Conclusion: So far MVRepair is technically feasible in patients with an acute MV endocarditis, it is a safe and effective technique and has resulted in patients free of recurrent infection. Valve repair should be carried out whenever possible in this patient group.