Outcome of surgical management for active mitral native valve infective endocarditis: a collective review of 57 patients

Miura, Takashi; Hamawaki, Masayoshi; Hazama, Shiro; Hashizume, Koji; Ariyoshi, Tsuneo; Sumi, Misa; Furumoto, Akitsugu; Saito, Nobuo; Tsuneto, Akira; Eishi, Kiyoyuki

doi:10.1007/s11748-014-0377-y

Cited by 18 publications

(17 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although previous systematic review [14] and reports from the western countries such as Ruttmann et al [15] and Solari et al [16] have shown significant survival benefits after mitral repair in comparison to replacement during active IE, in contrast, we could not clearly identify the same benefit-just trend toward better survival in repair group. These findings are almost the same as reports from eastern countries such as Miura et al [17] and Jung et al [18]. This suggests that survival differences could be from multifactorial factors including ethnics, underlying mitral etiology (rheumatic vs degenerative), timing of surgery, causative organism, and severity of infection.…”

Section: Discussionsupporting

confidence: 87%

Comparison between mitral valve repair and replacement in active infective endocarditis

Tepsuwan

Rimsukcharoenchai

Tantraworasin

et al. 2019

Gen Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Background Mitral valve repair has been proved to provide better outcomes when compared with replacement in degenerative disease. However, it is still unclear that benefits of repair still remain in active endocarditis. Patient clinical conditions and severity of tissue destruction might limit successful durable repair. Methods Of all 247 patients who received surgery during active phase of native left-sided endocarditis from Jan 2006 to Dec 2017, 114 had mitral valve procedures due to active infection of mitral valve apparatus (38 repair and 76 replacement). Perioperative data and mid-term outcomes were retrospectively compared. Results Mean age was 46.4 years old. Repair group had significantly less patients with NYHA class IV (18.4% vs 56.6%, p = 0.001). Both groups had preserved ejection fraction but accompanied by severe pulmonary hypertension. Major organism was streptococci (50%) and timing of surgery was 11 days after diagnosis. Bypass and cross-clamp time were similar but repair group had significantly less combined procedures. Bi-leaflet involvement was common (47.4% vs 57.6%) and valve lesions were comparable. There was 13.2% of postoperative moderate to severe mitral regurgitation in repair group without recurrent endocarditis. Repair group tended to have better 5-year survival estimates (91.6% vs 70.0%, p = 0.08) with comparable reoperation rate (7.9% vs 2.6%). By logistic regression analysis, mitral valve replacement was more likely to be performed in patients with decompensated heart failure and combined procedures. Conclusions Mitral valve repair during active endocarditis can be safely performed with good mid-term outcomes, especially in selected group of patients without extremely high surgical risk.

show abstract

Section: Discussionsupporting

confidence: 87%

Comparison between mitral valve repair and replacement in active infective endocarditis

Tepsuwan

Rimsukcharoenchai

Tantraworasin

et al. 2019

Gen Thorac Cardiovasc Surg

View full text Add to dashboard Cite

show abstract

“…It has been previously shown that IE patients undergoing MV replacement have increased early and late mortality when compared to MV repair . Patients in the MV repair group were older, required more emergency operations and more frequent and higher doses of inotropic support, and had a higher rate of severe cardiac decompensation . In our systematic review, the surgical acuity was higher in the mitral valve replacement group (91% vs 85%; P < 0.05).…”

Section: Discussionmentioning

confidence: 75%

“…The perioperative characteristics of the patients and the articles included in the analysis are summarized in Tables and . There were no randomized control trials comparing the two procedures.…”

Section: Resultsmentioning

confidence: 99%

Mitral valve repair or replacement in native valve endocarditis? Systematic review and meta-analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Anterior leaflet lesions, commissural lesions, extensive leaflet destruction and paravalvular abscess may require different and often complex techniques for MV repair [14]. Annuloplasty using a prosthetic ring provides coaptation of leaflets, limits tension in the suture, prevents further dilation of the annulus allowing a stable late surgical result [2, 6, 8].…”

Section: Discussionmentioning

confidence: 99%

Role of mitral valve repair in active infective endocarditis: long term results

Rostagno

Carone

Stefàno

2017

J Cardiothorac Surg

View full text Add to dashboard Cite

BackgroundAlthough mitral valve repair is at present the technique of choice in mitral regurgitation (MR) due to degenerative valve disease, long term results in patients with active mitral infective endocarditis (IE) are still under evaluation.MethodsIn the study were included 34 consecutive patients (22 males; mean age, 60 years; range 32–84 years) referred to our institution between January 1, 2005 to December 31, 2011 who were treated with valve repair for mitral valve (MV) active infective endocarditis. Eighteen patients underwent isolated MV repair. Aortic valve replacement and respectively repair were performed in 9 and 2 patients with concomitant aortic involvement. Blood cultures were positive in 30 (17 Staphylococcus, 13 Streptococcus, 1 g negative, 2 enterococcus).ResultsFour patients died during hospital stay (11%) due to multi system organ failure as a consequence of severe septic shock (2 patients), cardiogenic shock (1 case) and respiratory failure (1 patient). At an average follow up of 48 months in patients discharged alive from hospital survival was 96.7% (29 out of 30). None developed more than mild- to moderate mitral valve regurgitation during follow-up and we found a significant improvement in functional capacity and left ventricular ejection fraction associated with a significant decrease of pulmonary artery pressure. The only recurrence of endocarditis occurred in a drug addict patient.ConclusionsPresent investigation suggest that in patients with active mitral valve endocarditis MV repair, when technically feasible, is associated with a favorable clinical long term outcome. None of the patients alive at the end of follow-up developed severe mitral regurgitation. Moreover mortality and reinfection rate are uncommon and functional improvement.

show abstract

Outcome of surgical management for active mitral native valve infective endocarditis: a collective review of 57 patients

Abstract: Mitral valve repair is appropriate to prevent postoperative cardiac-related events. Reducing in-hospital mortality due to uncontrolled infection remains challenging. Early surgery may be reasonable for patients with small non-hemorrhagic infarction.

Cited by 18 publications

References 25 publications

Comparison between mitral valve repair and replacement in active infective endocarditis

Comparison between mitral valve repair and replacement in active infective endocarditis

Mitral valve repair or replacement in native valve endocarditis? Systematic review and meta-analysis

Role of mitral valve repair in active infective endocarditis: long term results

Contact Info

Product

Resources

About