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(Circulation. 2005;111:2532-2536.)
© 2005 American Heart Association, Inc.

Valvular Heart Disease

Long-Term Results of Mitral Valve Repair in Active Endocarditis

Rachid Zegdi, MD, PhD; Mohamed Debièche, MD; Christian Latrémouille, MD, PhD; Djoulène Lebied, MD; Catherine Chardigny, MD, PhD; Jean-Michel Grinda, MD; Sylvain Chauvaud, MD; Alain Deloche, MD; Alain Carpentier, MD, PhD; Jean-Noël Fabiani, MD

From René Descartes University (R.Z., C.L., A.D., A.C., J.-N.F.) and the Department of Cardiovascular Surgery, Georges Pompidou European Hospital (R.Z., M.D., C.L., D.L., C.C., J.-M.G., S.C., A.D., A.C., J.-N.F.), Paris, France.

Reprint requests to Dr Rachid Zegdi, Hôpital Européen Georges Pompidou, Service de Chirurgie Cardiovasculaire, 20 Rue Leblanc, 75908 Paris, France.

Received November 2, 2004; revision received January 31, 2005; accepted February 4, 2005.

Background— Several investigators have reported the feasibility of mitral valve repair in active endocarditis, but the long-term results are still unknown.

Methods and Results— We reviewed 37 consecutive patients who underwent mitral valve repair with the Carpentier technique for active endocarditis in our center between 1989 and 1994. This repair involved prosthetic annuloplasty in 31 patients (84%), valve resection in 31 (84%), chordal shortening or transposition in 19 (51%), pericardial patch in 16 (43%), and direct suture of leaflet perforation in 4 (11%). Associated procedures were primarily aortic valve repair or replacement in 11 (30%) and tricuspid repair in 2 (6%). Early complications included 1 operative death (3%; 95% CI, 0 to 15.5) and 1 reoperation for pericardial patch dehiscence. Recurrence of endocarditis was observed in 1 patient (3%; 95% CI, 0 to 16). The 10-year survival rate and freedom from mitral valve reoperation were 80% (95% CI, 66 to 94) and 91% (95% CI, 81 to 100), respectively. At 10 years, most patients (96%) were in good functional status (NYHA class I to II) with no or trivial mitral regurgitation (92%) on echocardiography.

Conclusions— Mitral valve repair using Carpentier’s techniques in patients with active endocarditis offers very good long-term results with a low rate of recurrence or reoperation.

Key Words: mitral valve • endocarditis • valves

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