Contemporary results of mitral valve repair for infective endocarditis

Iung, Bernard; Rousseau-Paziaud, Juliette; Cormier, Bertrand; Garbarz, Eric; Fondard, Olivier; Brochet, Éric; Acar, Christophe; Couëtil, Jean-Paul; Hvass, Ulrik; Vahanian, Alec

doi:10.1016/j.jacc.2003.09.034

Cited by 120 publications

(48 citation statements)

References 27 publications

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“…Repair in active endocarditis was associated with a higher rate of major adverse cardiac events but had equivalent survival to those with fully treated endocarditis. (19) Only 30% of our patients with mitral endocarditis were amenable for repair and they had no valve related mortality but 33% had major adverse cardiac events.…”

Section: Infective Endocarditismentioning

confidence: 84%

Long term outcome and EuroSCORE II validation in native valve surgery for active infective endocarditis in a South African cohort

Koshy

Engel

Carrara

et al. 2018

SAHJ

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There has been little change in the mortality from infective endocarditis, despite the diagnostic and therapeutic advances made in the last 25 years. The current in-hospital mortality rate for patients with IE is 15% -20%, with 1-year mortality approaching 40%. The morbidity associated with infective endocarditis includes: valvular incompetence, embolisation, cerebrovascular accidents and congestive heart failure which have influenced the surgical approaches to a great extent. Infective endocarditis is a significant problem in sub-Saharan Africa and is related to a high prevalence of rheumatic heart disease among the young indigent population. Africa has the highest burden of rheumatic heart disease contributing 17% -43% of all heart disease.

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Section: Infective Endocarditismentioning

confidence: 84%

Long term outcome and EuroSCORE II validation in native valve surgery for active infective endocarditis in a South African cohort

Koshy

Engel

Carrara

et al. 2018

SAHJ

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“…Mitral valve repair is associated with lower perioperative morbidity and mortality, better preservation of left ventricular function, avoidance of long-term anticoagulation and the associated risks of bleeding, a low rate of thromboembolic complications, a low risk of infective endocarditis, excellent freedom from reoperation, and improved long-term survival. [11][12][13] Although individual centers with an interest in mitral valve surgery have demonstrated high repair rates, the majority of patients having mitral valve surgery in North America continue to receive a replacement rather than a repair. 14 We observed a dramatic effect of hospital procedural volume on mitral valve repair rates, with repair rates climbing from 47.7% in the lowest-volume quartile to 77.4% in the highest-volume quartile.…”

Section: Circulation February 20 2007mentioning

confidence: 99%

Influence of Hospital Procedural Volume on Care Process and Mortality for Patients Undergoing Elective Surgery for Mitral Regurgitation

et al. 2007

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Background-Few studies have examined the procedural volume-outcome relationship for heart valve surgery. None have examined process of care factors that may be mediators of this association. Methods and Results-This was a retrospective review of outcomes for 13 614 patients having elective surgery for mitral regurgitation between 2000 and 2003 in 575 North American centers participating in the Society of Thoracic Surgeons National Cardiac Database. Hospital annual mitral valve volume varied widely from 22 cases per year in the lowest-volume quartile to 394 in the highest. Unadjusted mortality rates decreased from 3.08% in the lowest-volume category to 1.11% in the highest-volume category. The risk-adjusted odds ratio for mortality in the highest-volume category compared with the lowest was 0.48 (95% confidence interval 0.28 to 0.82). The rates of mitral valve repair increased from 47.7% in the lowest-volume quartile to 77.4% in high-volume hospitals (PϽ0.0001). Similarly, the rates of bioprosthetic valve use for patients aged Ͼ65 years rose from 59% in the lowest-volume quartile to 75% in the highest-volume quartile (Pϭ0.0002). The association between volume and mortality was still significant but attenuated when the risk adjustment was modified to adjust for mitral valve repair versus replacement. Conclusions-Hospital procedural volume was associated with higher frequency of valve repair, higher frequency of prosthetic valve usage in elderly patients, and lower adjusted operative mortality. Differences in care process may contribute to improved outcomes in higher-volume centers.

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“…For example, Iung et al demonstrated that mitral valve repair was feasible in 81% of patients with IE and resulted in an early mortality of 3.2% and a 7-year event-free survival of 78%, 1 Podesser et al reported that actuarial survival at 5 years was 87±12.7%, 2 and both Muehrcke et al 3 and Sternik et al 4 demonstrated that early and late mortality and event-free survival were better in patients undergoing mitral valve repair compared with replacement for acute endocarditis. Although comparison of patients undergoing valve repair and replacement is difficult because of the variation in the clinical condition of the patients at the time of surgery, mitral valve repair still remains an attractive procedure because of better preservation of left ventricular function and a lower incidence of valve-related events.…”

Section: Discussionmentioning

confidence: 99%

Mitral Valve Repair in Patients With Infective Endocarditis

Yamaguchi

Eishi

Yamachika

et al. 2006

Circ J

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Contemporary results of mitral valve repair for infective endocarditis

Abstract: Mitral valve repair is frequently feasible and gives good results in patients with infective endocarditis. Patients operated on for acute endocarditis experience more events during follow-up than those operated on after healed endocarditis but have excellent late survival.

Cited by 120 publications

References 27 publications

Long term outcome and EuroSCORE II validation in native valve surgery for active infective endocarditis in a South African cohort

Long term outcome and EuroSCORE II validation in native valve surgery for active infective endocarditis in a South African cohort

Influence of Hospital Procedural Volume on Care Process and Mortality for Patients Undergoing Elective Surgery for Mitral Regurgitation

Mitral Valve Repair in Patients With Infective Endocarditis

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