[Mitral Valve Surgery for Active Infective Endocarditis:Techniques to Preserve Native Valve].

ABSTRACT

OBJECTIVE: In surgery for active infective endocarditis (aIE), it is often difficult to achieve balance between thorough debridement and preservation of native valve. This study aimed to evaluate the validity of our native valve preservation techniques including leaflet peeling and autologous pericardial reconstruction. METHODS: From January 2012 to December 2021, 41 consecutive patients underwent mitral valve surgery for aIE. Twenty-four patients who underwent mitral valve plasty (group P) and 17 patients who underwent mitral valve replacement (group R) were retrospectively compared regarding early and long-term outcomes. RESULTS: Patients in the group P were significantly younger and had fewer preoperative shock, congestive heart failure and cerebral embolism. There was 18% in-hospital mortality in the group R, but none in the group P. In the group P, one patient underwent valve replacement for recurrence of mitral regurgitation 3-years after surgery, and 5-year freedom from mitral reoperation was 93%. CONCLUSIONS: Techniques of leaflet peeling and autologous pericardial reconstruction improved the feasibility of mitral valve plasty for aIE, and the early and long-term outcomes were favorable.