Reconstruction of the free margin of the anterior mitral leaflet with autologous pericardium in active infected endocarditis

Abstract

In patients with active infective endocarditis mitral valve repair is better than mitral valve replacement, but it remains a challenge when there has been massive destruction of the rough zone of the anterior leaflet. We report a technical modification of mitral valve repair for advanced active infective endocarditis in which a widely infected rough zone and the chordae were successfully replaced with autologous pericardium and multiple artificial chordae. The procedure described here is capable of improving the prospects of mitral valve repair in advanced infective endocarditis.

Long-term Performance of Fresh Autologous Pericardium for Mitral Valve Leaflet Repair

“…1 FAP and GAP, as well as glutaraldehyde-fixed bovine pericardium, have been used for MV repair with excellent results. [1][2][3]5,[7][8][9][10][11][12][13][14][15][16][17][18] GAP, although associated with reduced immunogenicity, improved durability, and resistance to degeneration, 8,19 may be associated with an increased risk of tissue failure and calcification. 4,20 Glutaraldehyde forms extremely stable cross-links in collagenous tissue through the formation of covalent bonds, contributing to its improved durability and biomechanical properties.…”