Mitral valve repair in infective endocarditis is not inferior to valve replacement: results from a Spanish nationwide prospective registry

被引：13

作者：

Cuerpo, Gregorio P. ^{[1
,10
]}

Valerio, M. ^{[2
]}

Pedraz, A. ^{[1
]}

Rodriguez-Abella, H. ^{[1
]}

Mestres, Carlos A. ^{[3
]}

Obrador, Eduardo Quintana ^{[4
]}

Gonzalez-Calle, Antonio ^{[5
]}

Rodriguez Alvarez, Regino ^{[6
]}

Munoz Garcia, Patricia ^{[2
,7
,8
,9
]}

Bouza, Emilio ^{[2
,7
,8
,9
]}

Fernandez Sanchez, Fernando ^{[11
]}

Noureddine, Mariam ^{[11
]}

Rosas, Gabriel ^{[11
]}

de la Torre Lima, Javier ^{[11
]}

Aramendi, Jose ^{[12
]}

Bereciartua, Elena ^{[12
]}

Jose Blanco, Maria ^{[12
]}

Blanco, Roberto ^{[12
]}

Victoria Boado, Maria ^{[12
]}

Campana Lazaro, Marta ^{[12
]}

Crespo, Alejandro ^{[12
]}

Goikoetxea, Josune ^{[12
]}

Ramon Iruretagoyena, Jose ^{[12
]}

Irurzun Zuazabal, Josu ^{[12
]}

Lopez-Soria, Leire ^{[12
]}

Montejo, Miguel ^{[12
]}

Nieto, Javier ^{[12
]}

Rodrigo, David ^{[12
]}

Rodriguez, David ^{[12
]}

Rodriguez, Regino ^{[12
]}

Vitoria, Yolanda ^{[12
]}

Voces, Roberto ^{[12
]}

Garcia Lopez, Ma Victoria ^{[13
]}

Ivanova Georgieva, Radka ^{[13
]}

Ojeda, Guillermo ^{[13
]}

Rodriguez Bailon, Isabel ^{[13
]}

Ruiz Morales, Josefa ^{[13
]}

Maria Cuende, Ana ^{[14
]}

Echeverria, Tomas ^{[14
]}

Fuerte, Ana ^{[14
]}

Gaminde, Eduardo ^{[14
]}

Angel Goenaga, Miguel ^{[14
]}

Idigoras, Pedro ^{[14
]}

Antonio Iribarren, Jose ^{[14
]}

Izaguirre Yarza, Alberto ^{[14
]}

Kortajarena Urkola, Xabier ^{[14
]}

Reviejo, Carlos ^{[14
]}

Carrasco, Rafael ^{[15
]}

Climent, Vicente ^{[15
]}

Llamas, Patricio ^{[15
]}

机构：

[1] Hosp Gen Univ Gregorio Maranon, Serv Cirugia Cardiaca, Madrid, Spain

[2] Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, Madrid, Spain

[3] Univ Zurich, Univ Hosp Zurich, Dept Cardiovasc Surg, Zurich, Switzerland

[4] Hosp Clin Barcelona, Serv Cirugia Cardiovasc, Barcelona, Spain

[5] Hosp Univ Virgen del Rocio, Serv Cirugia Cardiaca, Unidad Corazon, Seville, Spain

[6] Hosp Univ Cruces, Serv Microbiol & Enfermedades Infecciosas, Bilbao, Spain

[7] Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain

[8] CIBERES, CIBER Enfermedades Resp, CB06-06-0058, Madrid, Spain

[9] Univ Complutense Madrid, Fac Med, Madrid, Spain

[10] Hosp Gen Univ Gregorio Maranon, Dept Cardiac Surg, Madrid, Spain

[11] Hosp Costa del Sol, Marbella, Spain

[12] Hosp Univ Cruces, Bilbao, Spain

[13] Hosp Univ Virgen de la Victoria, Malaga, Spain

[14] Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

[15] Hosp Gen Univ Alicante, Alicante, Spain

[16] Complejo Hosp Univ A Coruna, La Coruna, Spain

[17] Complejo Hosp Univ Huelva, Huelva, Spain

[18] Hosp Univ Canarias, Canarias, Spain

[19] Hosp Reg Univ Malaga, Malaga, Spain

[20] Hosp Univ Cent Asturias, Oviedo, Spain

[21] Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain

[22] Hosp Gen Univ Gregorio Maranon, Madrid, Spain

[23] Hosp Univ La Paz, Madrid, Spain

[24] Hosp Univ Marques de Valdecilla, Santander, Spain

[25] Hosp Univ Puerta de Hierro, Madrid, Spain

[26] Hosp Univ Ramon y Cajal, Madrid, Spain

[27] Hosp Univ Virgen de las Nieves, Granada, Spain

[28] Hosp Univ Virgen Macarena, Seville, Spain

[29] Hosp Univ Virgen del Rocio, Seville, Spain

[30] Hosp San Pedro, Logrono, Spain

[31] Hosp Santa Creu & Sant Pau, Barcelona, Spain

[32] Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

[33] Hosp Santiago Apostol, Vitoria, Spain

[34] Hosp SAS Linea Concepcion, Cadiz, Spain

[35] Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

[36] Hosp Txagorritxu, Vitoria, Spain

[37] Hosp Virgen de la Salud, Toledo, Spain

[38] Hosp Rafael Mendez, Lorca Murcia, Spain

[39] Hosp Univ San Cecilio, Granada, Spain

[40] Hosp Son Llatzer, Palma De Mallorca, Spain

[41] Hosp Univ Miguel Servet, Zaragoza, Spain

[42] Hosp Gen Univ Santa Lucia, Cartagena, Spain

[43] Hosp Univ Son Espases, Palma De Mallorca, Spain

[44] Complejo Hosp Univ Albacete, Albacete, Spain

来源：

GENERAL THORACIC AND CARDIOVASCULAR SURGERY | 2019年 / 67卷 / 07期

关键词：

Infectious endocarditis; Mitral valve reparation; Mitral valve replacement; Cardiac surgery; SURGERY;

D O I：

10.1007/s11748-019-01063-0

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

IntroductionInfective endocarditis (IE) still carries high morbidity and mortality and frequently requires surgery. The benefit of mitral valve repair (MVr) in the setting of IE is yet to be proven. The goal of this study was to assess the results of MVr in patients with IE after a minimum follow-up of 1year.MethodsThis study is based on a Spanish nationwide prospective registry that included patients operated on for native mitral valve IE. The collaborating Institutions pooled their pre-, peri-, and postoperative data into the database of the GAMES group [Grupo de Apoyo al Manejo de la EndocarditiS (Group for support and management of infective endocarditis)].ResultsData from 27 hospitals were recorded and 3524 cases of active IE identified between 2008 and 2016. There were 1513 cases of mitral IE, of which 898 involved native valves. Of these, 437 patients underwent surgical treatment, and 369 completed the 1-year follow-up. The valve was repaired in 68 cases (18.4%). Preoperative groups were comparable (EuroSCORE MVr 7.7 vs MVR 8.0; p=ns). Mortality in the repair group was inferior to that in the replacement group (16.2% vs 27.2%, p=0.058). At 1year, mortality remained higher in the replacement group: 3.7% vs 2.9%. Relapse of the infection was slightly more frequent in the repair group (7.1% vs 3.7%; p=ns), although this did not lead to higher rates of reintervention (MVr/MVR: 2.9% vs 4.9%).ConclusionMVr is an attractive option for specific patients with IE and does not seem to negatively impact on relapses.

引用

页码：585 / 593

页数：9

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