Reconstruction of mitral valve chordae and leaflets with one piece of autologous pericardium in extensively destructed mitral valve due to active infective endocarditis

Abstract

A 20-year-old female patient underwent urgent surgery for extensive mitral valve endocarditis. All marginal chordae and rough zone of A3 leaflet, posterior commissure leaflet, and P3 leaflet down to the annulus became defective after complete debridement of infected tissues. After annular plication, defective leaflets and chordae were reconstructed with a piece of triangular shaped autologous pericardium. Top of the pericardium was directly attached to the posterior papillary muscle, side edges to remnant leaflets, and the base to the annulus, thus substituting for chordae and leaflets at once. No mitral regurgitation was observed during 3 years of follow-up after the operation.

Midterm results after seamless patch mitral reconstruction

“…We previously described our technique and early outcome of this seamless patch reconstruction. 6 , 7 Our previous study demonstrated its effectiveness and reproducibility in the short-term. The results of our current study are consistent with previous reports of the fresh autologous pericardium.…”

“…The details of the technique are also described in our previous reports. 6 , 7

Figure 1 A-D, Schema of SRT applied to 1- or 2-segment involvement.

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“…To repair such pathologies, we reported our technique of “seamless” patch reconstruction using a glutaraldehyde-treated autologous pericardium. 6 , 7 This technique uses a single piece of pericardium patch to cover the defective or diseased mitral leaflet with a good early outcome. As we have broadened the application of our technique to more extensive valve pathologies, we aimed to characterize the association between the long-term outcome and the extent of segments repaired.…”

Long-term Outcome of Extensive Mitral Valve Reconstruction With Autologous Pericardium and Artificial Chordae for Treatment of Destructive Active Infective Endocarditis of the Mitral Valve

“…Some authors have reported extensive reconstruction of the mitral valve lea ets and chordae using autologous or bovine pericardium with or without chordal reconstruction for such devastating cases. These reports described only the short-or mid-term results; the long-term outcomes remain unclear because the durability of the pericardial lea et is still controversial [2][3][4][5]. Furthermore, these reports included repair for chronic endocarditis, whereas repair for active endocarditis may be more challenging.…”

Infecções sistêmicas por Streptococcus gordonii e a correlação com a saúde oral: um levantamento de casos na literatura

“…1,21 Bacteremias decorrentes de infecções odontogênicas podem levar a quadros como endocardite infecciosa, sinusite, abscessos, osteomielite e infecções em próteses. 1,3,13,14,20,22,23 A revisão demonstrou que a endocardite infecciosa (EI) foi a infecção mais associada ao S. Gordonii, 7,15,17,20,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] com 12 casos em homens e 11 casos em mulheres e tendo a febre e a fadiga como os achados clínicos mais comuns, podendo acometer tanto a válvula mitral, quanto a aórtica.…”