Published Online
on May 2, 2005

A more recent version of this article appeared on May 17, 2005

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Submitted on November 2, 2004
Revised on January 31, 2005
Accepted on February 4, 2005

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, and 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.

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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