Mitral valve repair for infective endocarditis: Kobe experience

被引:8
作者
Okada, Yukikatsu [1 ]
Nakai, Takeo [1 ]
Muro, Takashi [1 ]
Ito, Hisato [2 ]
Shomura, Yu [2 ]
机构
[1] Midori Hosp, Heart Valve Ctr, Kobe, Hyogo, Japan
[2] Mie Univ, Dept Thorac & Cardiovasc Surg, Sch Med, Tsu, Mie, Japan
关键词
Endocarditis; bacterial; mitral valve insufficiency; pericardium; prostheses and implants; transplantation; autologous; treatment outcome; OUTCOMES; SURGERY;
D O I
10.1177/0218492320947586
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives We retrospectively analyzed our experience of mitral valve repair for native mitral valve endocarditis in a single institution. Methods From January 1991 to October 2011, 171 consecutive patients underwent surgery for infective endocarditis. Of these, 147 (86%) had mitral valve repair. At the time of surgery, 98 patients had healed (group A) and 49 had active infective endocarditis (group B). Repair procedures included resection of all infected tissue and thick restricted post-infection tissue, leaflet and annulus reconstruction with treated autologous pericardium, chordal reconstruction with polytetrafluoroethylene sutures, and ring annuloplasty if necessary. Fifty-two (35%) patients required concomitant procedures. The study endpoints were overall survival, freedom from reoperation, and freedom from valve-related events. The median follow-up was 78 months. Results There was one hospital death (hospital mortality 0.7%). Survival at 10 years was 88.5% +/- 3.5% with no significant difference between the two groups (p = 0.052). Early reoperation was required in 4 patients in group B due to persistent infection or procedure failure. Freedom from reoperation at 5 years was 99% +/- 1.0% in group A and 89.6 +/- 4.0% in group B (p = 0.024). Event-free survival at 10 years was 79.3% +/- 4.8% (group A: 83.4% +/- 5.9%, group B: 72.6% +/- 6.9%, p = 0.010). Conclusions Mitral valve repair was highly successful using autologous pericardium, chordal reconstruction, and ring annuloplasty if required. Long-term results were acceptable in terms survival, freedom from reoperation, and event-free survival. Mitral valve repair is recommended for mitral infective endocarditis in most patients.
引用
收藏
页码:384 / 389
页数:6
相关论文
共 17 条
[1]   Surgical Management of Endocarditis: The Society of Thoracic Surgeons Clinical Practice Guideline [J].
Byrne, John G. ;
Rezai, Katayoun ;
Sanchez, Juan A. ;
Bernstein, Richard A. ;
Okum, Eric ;
Leacche, Marzia ;
Balaguer, Jorge M. ;
Prabhakaran, Shyam ;
Bridges, Charles R. ;
Higgins, Robert S. D. .
ANNALS OF THORACIC SURGERY, 2011, 91 (06) :2012-2019
[2]  
CHAUVAUD S, 1991, J THORAC CARDIOV SUR, V102, P171
[3]   VALVE REPAIR IN ACUTE ENDOCARDITIS [J].
DREYFUS, G ;
SERRAF, A ;
JEBARA, VA ;
DELOCHE, A ;
CHAUVAUD, S ;
COUETIL, JP ;
CARPENTIER, A .
ANNALS OF THORACIC SURGERY, 1990, 49 (05) :706-713
[4]   Mitral valve repair and replacement in endocarditis: A systematic review of literature [J].
Feringa, Harm H. H. ;
Shaw, Leslee J. ;
Poldermans, Don ;
Hoeks, Sanne ;
van der Wall, Ernst E. ;
Dion, Robert A. E. ;
Bax, Jeroen J. .
ANNALS OF THORACIC SURGERY, 2007, 83 (02) :564-571
[5]   Impact of early surgery in the active phase on long-term outcomes in left-sided native valve infective endocarditis [J].
Funakoshi, Shunsuke ;
Kaji, Shuichiro ;
Yamamuro, Atsushi ;
Tani, Tomoko ;
Kinoshita, Makoto ;
Okada, Yukikatsu ;
Furukawa, Yutaka .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2011, 142 (04) :836-U365
[6]   Surgical treatment of mitral valve endocarditis in North America [J].
Gammie, JS ;
O'Brien, SM ;
Griffith, BP ;
Peterson, ED .
ANNALS OF THORACIC SURGERY, 2005, 80 (06) :2199-2204
[7]   Mitral valve repair or replacement in native valve endocarditis? Systematic review and meta-analysis [J].
Harky, Amer ;
Hof, Alexander ;
Garner, Megan ;
Froghi, Saied ;
Bashir, Mohamad .
JOURNAL OF CARDIAC SURGERY, 2018, 33 (07) :364-371
[8]  
HENDREN WG, 1992, J THORAC CARDIOV SUR, V103, P124
[9]   Repair of infected mitral valves: what have we learned? [J].
Hu, Yu-Ning ;
Wan, Song .
SURGERY TODAY, 2018, 48 (10) :899-908
[10]   Nationwide cohort study of mitral valve repair versus replacement for infective endocarditis [J].
Lee, Hsiu-An ;
Cheng, Yu-Ting ;
Wu, Victor Chien-Chia ;
Chou, An-Hsun ;
Chu, Pao-Hsien ;
Tsai, Feng-Chun ;
Chen, Shao-Wei .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2018, 156 (04) :1473-+