Risk of annuloplasty and patch use in infective endocarditis mitral valve repair

The incidence of infective endocarditis is 3-10 per 100,000 people per year. Risk factors for this disease include heart-valve disease, the implantation of a prosthetic valve or intra-cardiac devices, drug use and patient immunodeficiency. A 38-year-old drug-using man with a history of mitral valve surgery with patch reconstruction and annuloplasty ring implantation due to infective endocarditis was admitted to the hospital because of recurrence of mitral valve endocarditis. Surgery confirmed the unaffected patch in the posterior leaflet and the ring affected by an abscess cavity. Explantation of the annuloplasty ring and implantation of a mechanical valve prothesis was performed. Advances in techniques of mitral valve repair, including NeoChords and patch use, make this procedure feasible for more and more patients with mitral valve infective endocarditis. The use of a patch appears to be a safe benefit for the patient. There is no clear opinion on the unconditional use of annuloplasty ring during mitral valve repair in the area of infective endocarditis. Moreover, the presented case in correlation with literature presents annuloplasty ring as a risk factor for infective endocarditis relapse.