J.Jpn. Surg. Soc.. 110(1): 3-6, 2009

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Feature topic

SURGICAL TREATMENT OF MITRAL VALVE ENDOCARDITIS

Mitral valve repair is considered to be the procedure of choice for any type of mitral regurgitation, including infective endocarditis, in terms of left ventricular function and event-free survival. We reviewed 120 consecutive patients who underwent mitral valve repair for active or healed endocarditis between 1991 and 2008. The repair rate for patients with infective endocarditis was 90% during the same period. The patients comprised 72 men and 48 women whose mean age was 48±17 years. Of the 120 patients, 40 underwent mitral valve repair during the active phase of infective endocarditis. The repair procedures included patch grafting using glutaraldehyde-treated autologous pericardium in 39 patients and chordal reconstruction using expanded polytetrafluoroethylene (ePTFE) in 57 patients which were combined with a prosthetic ring in 82 patients. The 10-year survival rates including hospital death and freedom from reoperation were 92±4% and 96±2%, respectively. Mitral valve repair for active or healed endocarditis can be performed with low operative mortality rates. Complex mitral valve repair using autologous pericardium and/or ePTFE for neochordae expands the possibility of repair, is durable, and is associated with excellent long-term results.

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