Mitral valve repair provides improved event-free survival in infective endocarditis

2005 ◽  
Vol 53 (S 01) ◽  
Author(s):  
E Ruttmann ◽  
G Pölzl ◽  
C Legit ◽  
O Chevtchik ◽  
S Müller ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Event Free Survival ◽  
Valve Repair ◽  
Free Survival

scholarly journals Mitral valve repair for infective endocarditis: Kobe experience

2020 ◽  
Vol 28 (7) ◽  
pp. 384-389
Author(s):  
Yukikatsu Okada ◽  
Takeo Nakai ◽  
Takashi Muro ◽  
Hisato Ito ◽  
Yu Shomura
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Event Free Survival ◽  
Valve Repair ◽  
Free Survival ◽  
Autologous Pericardium ◽  
Ring Annuloplasty ◽  
Group A ◽  
Group B

Objectives We retrospectively analyzed our experience of mitral valve repair for native mitral valve endocarditis in a single institution. Methods From January 1991 to October 2011, 171 consecutive patients underwent surgery for infective endocarditis. Of these, 147 (86%) had mitral valve repair. At the time of surgery, 98 patients had healed (group A) and 49 had active infective endocarditis (group B). Repair procedures included resection of all infected tissue and thick restricted post-infection tissue, leaflet and annulus reconstruction with treated autologous pericardium, chordal reconstruction with polytetrafluoroethylene sutures, and ring annuloplasty if necessary. Fifty-two (35%) patients required concomitant procedures. The study endpoints were overall survival, freedom from reoperation, and freedom from valve-related events. The median follow-up was 78 months. Results There was one hospital death (hospital mortality 0.7%). Survival at 10 years was 88.5% ± 3.5% with no significant difference between the two groups ( p = 0.052). Early reoperation was required in 4 patients in group B due to persistent infection or procedure failure. Freedom from reoperation at 5 years was 99% ± 1.0% in group A and 89.6 ± 4.0% in group B ( p = 0.024). Event-free survival at 10 years was 79.3% ± 4.8% (group A: 83.4% ± 5.9%, group B: 72.6% ± 6.9%, p = 0.010). Conclusions Mitral valve repair was highly successful using autologous pericardium, chordal reconstruction, and ring annuloplasty if required. Long-term results were acceptable in terms survival, freedom from reoperation, and event-free survival. Mitral valve repair is recommended for mitral infective endocarditis in most patients.

scholarly journals Acute response of right ventricular function following transcatheter mitral valve repair

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Sugiura ◽  
M.W Weber ◽  
N.T Tabata ◽  
S.Z Zimmer ◽  
U.B Becher ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Right Ventricular ◽  
Mitral Valve Repair ◽  
Adverse Outcomes ◽  
Left Ventricular Ejection ◽  
Event Free Survival ◽  
Valve Repair ◽  
Free Survival ◽  
Transcatheter Mitral Valve Repair ◽  
Increased Risk

Abstract Background Little is known about early right ventricular (RV) response to transcatheter mitral valve repair (TMVR) and its association with clinical outcomes. We assessed the early effect of TMVR on the RV function (RVF) and sought to investigated the prognostic impact of post-procedural RV dysfunction. Methods From January 2011 through April 2019, consecutive patients who underwent MitraClip for severe mitral regurgitation were analyzed. We excluded patients in which the evaluation of RVF were un available. RV dysfunction was defined by an RV fractional area change (RVFAC) <35% or tricuspid annular planar systolic excursion (TAPSE) <16 mm. A Cox proportional regression analysis was conducted to investigate the association of post-procedural RV dysfunction with adverse outcomes (all-cause mortality and rehospitalization due to heart failure [HF]). Results A total of 403 patients were analyzed.Overall, the mean age was 78 years old and 59% of patients were male. The median left-ventricular ejection fraction (LVEF) was 46.1% [IQR 33.1–59.4], RVFAC was 41.9% [IQR 32.9–49.5], and TAPSE was 17 mm [IQR 14–22]. While 68 patients showed an acute improvement of RVF (35% of patients with baseline RV dysfunction), 51 patients (25% of patients with baseline normal RVF) showed an acute worsening of RVF. In patients with baseline normal RVF, atrial fibrillation (OR 4.57, 95% CI 1.56–13.40, p=0.006, HF duration >18 months (OR 2.95, 95% CI 1.32–6.60, p=0.009), LVEF <50% (OR 3.09, 95% CI 1.32–7.25, p=0.009), and tricuspid regurgitation≥3+ (OR 5.62, 2.28–13.90, p<0.001)were associated with an increased risk of acute worsening of RVF. By contrast, in patients with baseline RV dysfunction, HF duration >18 months (OR 0.43, 95% CI 0.22–0.85, p=0.01) and larger RV volume (OR 0.98, 95% CI 0.97–0.99, p<0.001) were associated with less probability of acute RVF improvement. The event-free survival was significantly different according to the subgroup of variation of RVF (p=0.003). Furthermore, post-procedural RV dysfunction was associated with an increased risk of outcomes (adjusted-HR 2.38, 95% CI 1.28–4.43, p=0.006). Conclusion Both acute improvement and worsening of RVF can be observed after TMVR. Post-procedural RV dysfunction is an independent predictor of adverse outcomes. Event-free survival curve Funding Acknowledgement Type of funding source: None

scholarly journals Mitral valve repair using edge-to-edge technique in various situations: real-world experiences

2019 ◽  
Vol 56 (6) ◽  
pp. 1110-1116 ◽  
Author(s):  
Sameer A Hirji ◽  
Fernando Ramirez Del Val ◽  
Farhang Yazdchi ◽  
Jiyae Lee ◽  
Julius Ejiofor ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Real World ◽  
Systolic Anterior Motion ◽  
Event Free Survival ◽  
Valve Repair ◽  
Free Survival ◽  
Cumulative Survival ◽  
Ring Annuloplasty ◽  
Transaortic Approach

AbstractOBJECTIVESEdge-to-edge (E2E) mitral valve repair (MVP) is a versatile technique used in various situations for mitral regurgitation (MR). This technique has been regaining attention, given the increasing use of the MitraClip procedure. This real-world study evaluates the durability of the E2E technique in different settings.METHODSFrom January 2002 to May 2015, a total of 303 patients with at least moderate MR who underwent E2E MVP were identified. Patients undergoing isolated MVP (n = 133) and concomitant coronary artery bypass grafting or other valvular procedures (N = 170) were included. Cox proportional hazards modelling was used to evaluate the risk factors for cumulative survival, or MV event (i.e. MV reintervention or MR recurrence) while event-free survival—defined as time to composite outcome of either death or MV event—was determined using competing risk Kaplan–Meier analysis. Median follow-up duration was 6.9 (interquartile range 5.8) years.RESULTSThe most common MR aetiology was myxomatous (34%), followed by Barlow’s disease (27.7%), and ischaemic (21.5%). E2E MVP was performed for the following indications: persistent MR (51.5%), systolic anterior motion prophylaxis (22.1%), transaortic approach (17.5%) and systolic anterior motion treatment post-MVP (8.9%). Concomitant ring annuloplasty was performed in 224 patients (73.9%). Operative mortality was 3.6% and MV event rate was 18.5%. Significant predictors of decreased survival included age, renal insufficiency, peripheral vascular disease and ischaemic MR aetiology (all P < 0.050). No ring annuloplasty (HR 2.79; P < 0.001) was the only significant predictor of MV events. Estimated event-free survival for the overall cohort was 8.5 years, and shortest for functional (non-ischaemic; 6.6 years) and ischaemic aetiology (5.5 years).CONCLUSIONSE2E repair is a versatile MVP technique, which can be used in prevention and treatment of systolic anterior motion, transaortic approach or with concomitant techniques, with reasonable outcomes. Ischaemic aetiology and absence of ring annuloplasty were associated with worse cumulative survival and MV event rates, respectively, which raises some concern in light of the expanding indication for MitraClip system.

scholarly journals Corrigendum to: Outcomes of mitral valve repair in acute native mitral valve infective endocarditis [Interact CardioVasc Thorac Surg 2019; doi:10.1093/icvts/ivz187]

2019 ◽  
Vol 29 (5) ◽  
pp. 820-820
Author(s):  
Mohamed El Gabry ◽  
Zaki Haidari ◽  
Fanar Mourad ◽  
Janine Nowak ◽  
Konstantinos Tsagakis ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair

Active infective endocarditis after mitral valve repair

2010 ◽  
Vol 58 (1) ◽  
pp. 49-52
Author(s):  
Takashi Miura ◽  
Kiyoyuki Eishi ◽  
Koji Hashizume ◽  
Shinichiro Taniguchi ◽  
Kazuyoshi Tanigawa ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Active Infective Endocarditis

Outcomes of mitral valve repair in acute native mitral valve infective endocarditis

2019 ◽  
Vol 29 (6) ◽  
pp. 823-829 ◽  
Author(s):  
Mohamed El Gabry ◽  
Zaki Haidari ◽  
Fanar Mourad ◽  
Janine Nowak ◽  
Konstantinos Tsagakis ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Limited Resection ◽  
Long Term Results ◽  
Valve Repair ◽  
Direct Closure ◽  
Complex Procedure ◽  
Hospital Stays

AbstractOBJECTIVESMitral valve repair (MVR) is considered the treatment of choice for mitral valve (MV) regurgitation. However, MVR in acute native MV infective endocarditis is technically challenging and not commonly performed. Our goal was to report our outcomes of MVR in acute native MV infective endocarditis.METHODSBetween January 2016 and December 2017, 35 patients presenting with acute native MV infective endocarditis underwent MVR. Primary end points were successful MVR and freedom from recurrent endocarditis. Secondary end point was the postoperative incidence of major adverse events.RESULTSThe mean age was 58 ± 13 years (74% men) and the median logistic EuroSCORE was 17.1%. Twenty patients underwent isolated MVR; the other 15 patients underwent concomitant procedures. MVR was performed with removal of the vegetation (vegectomy), limited resection of the infected tissue, direct closure of the defect, besides annuloplasty in all patients. Mean intensive care and hospital stays were 5 and 17 days, respectively. All-cause mortality was 11% (4/35) at 30 days and a total of 23% (8/35) within a follow-up period of 10 ± 7.7 months. Endocarditis recurred in 2 patients 15 and 8 months after surgery, respectively. Both underwent successful MV re-repair. Follow-up echocardiography indicated none-to-trace, mild or moderate regurgitation in 15, 10 and 2 patients, respectively.CONCLUSIONSAlthough MVR in acute native MV infective endocarditis is a complex procedure, it offers a treatment option for such patients with acceptable short-term results. Limited resection in addition to annuloplasty is our preferred method of repair. Nevertheless, long-term results in a larger cohort are still mandatory.

Combined aortic and mitral valve repair in active infective endocarditis

2005 ◽  
Vol 53 (7) ◽  
pp. 372-376 ◽  
Author(s):  
Hiroichiro Yamaguchi ◽  
Kiyoyuki Eishi ◽  
Shiro Yamachika ◽  
Kazuyoshi Tanigawa ◽  
Kenta Izumi ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Active Infective Endocarditis

Mitral Valve Repair for Infective Endocarditis in Children

2007 ◽  
Vol 84 (6) ◽  
pp. 2059-2065 ◽  
Author(s):  
Eva Maria Delmo Walter ◽  
Michele Musci ◽  
Nicole Nagdyman ◽  
Michael Hübler ◽  
Felix Berger ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair
Sign in / Sign up

Export Citation Format

Share Document