Chest, Vol 75, 314-319, Copyright © 1979 by American College of Chest Physicians

ARTICLES

Surgery for mitral valve endocarditis

RM Becker, W Frishman and RW Frater

The records of 20 patients who underwent mitral valve replacement for complications of bacterial endocarditis were reviewed. Although the indications for surgery were the same as those for patients with aortic endocarditis, major emboli (cerebral, coronary or retinal) prompted surgery in 8 of 20 patients, a much higher incidence than reported for surgery in aortic valve endocarditis. Eighteen of the patients had mitral regurgitation; 14 of these had severe congestive heart failure, but the development of congestive failure tended to be more insidious than in patients with aortic endocarditis. Continued septicemia despite appropriate antibiotics was the least common indication for surgery. Sixteen of the 20 patients were salvaged by surgery, although some had major residual deficits, related mainly to preoperative emboli. These results are a marked improvement in the expected 90-100 percent mortality rate for patients with these complications of endocarditis. The main reason for a poor result following surgery was temporization leading to continued deterioration of vital functions preoperatively. Reinfection of the prosthesis did not occur, and we do not consider duration of preoperative antibiotic therapy an important factor in the decision to perform surgery.

This article has been cited by other articles:

				G Doukas, M Oc, C Alexiou, A W Sosnowski, N J Samani, and T J Spyt Mitral valve repair for active culture positive infective endocarditis Heart, March 1, 2006; 92(3): 361 - 363. [Abstract] [Full Text] [PDF]

				D. D. Muehrcke, D. M. Cosgrove III, B. W. Lytle, P. C. Taylor, A. M. Burgar, C. P. Durnwald, and F. D. Loop Is There an Advantage to Repairing Infected Mitral Valves? Ann. Thorac. Surg., June 1, 1997; 63(6): 1718 - 1724. [Abstract] [Full Text]