Perrotta S, et al. - The clinicians performed this retrospective study to report their experience in surgical treatment of infective isolated mitral valve endocarditis (MVE). After valve replacement, MVE requiring surgical treatment was a challenging disease with high hospital mortality. In suitable endocarditis patients, mitral valve repair could be performed with excellent results. In a multivariable model, factors independently associated with mortality were age, diabetes, and EuroSCORE.

Methods

• Between January 2000 and December 2015, 128 patients who underwent 140 operations for MVE were included in this study.
• There were 109 (78%) operations for native and 31 (22%) operations for prosthetic valve endocarditis.
• The clinicians registered preoperative and postoperative characteristics and mortality of patients.
• Factors associated with mortality were identified with Cox regression.
• In this study, the mean follow-up period was 68 months (range 1–168 months) and 100% complete.

Results

• Thirteen deaths were reported within 30 days after the 140 operations (9%).
• The clinicians found severe perioperative complications in 59 (42%) operations.
• After the first operation, overall cumulative survival was 73% ± 4 at 5 years and 62 ± 5% at 10 years.
• Independent predictors of long-term mortality were age, diabetes, EuroSCORE II and perivalvular abscess.
• They performed valve repair in 76 (54%) operations and replacement in 64 (46%) operations.
• For repair, 30-day mortality was 1%.
• Five-year and 10-year cumulative survival was 86 ± 4% and 77 ± 6%, respectively.
• The 30-day mortality was found to be 19% and cumulative survival at 5 years and 10 years was 55 ± 7% and 41 ± 8%, respectively, in the replacement group.
• After operations for repair and replacement, postoperative complications occurred in 21% and 67%, respectively.
• For recurrent endocarditis, 10 (8%) patients had 12 reoperations.