Comparison of perioperative and recent efficacy of different mitral valve treatment strategies for mitral regurgitation caused by infective endocarditis / 中国医师进修杂志

ABSTRACT

Objective To compare the perioperative and recent efficacy of different mitral valve treatment strategies for mitral regurgitation caused by infective endocarditis. Methods From January 2009 to December 2014, 168 patients with mitral regurgitation caused by infective endocarditis underwent surgical treatment. Among them, mitral valve repair was performed in 65 patients (group A) and mitral valve replacement was performed in 103 patients (group B). Preoperative clinical profiles, perioperative details and follow-up data were reviewed retrospectively. Results There was no operative death in both groups. The cardiopulmonary bypass time and aorta clamp time were similar between the two groups. Intensive care stay was significantly shorter in group A [(1.4 ± 0.6) d] compared with group B [(1.9 ± 0.9) d](P＜0.05), and hospital stay had no significant difference between two groups (P＞0.05). Perioperative cerebral hemorrhage was observed in no patient in group A and 2 patients (1.9%) in group B. There was no in-hospital death in group A, and 2 patients (1.9%) in-hospital deaths occurred in group B. The difference was not statistically significant (P＞0.05). The incidence of heart-related adverse events in group A and group B was 6.2%(4/65) and 7.9%(8/101), and the incidence of infection related events was 0 and 3.0% (3/101) 3 years after operation (P＞0.05). Conclusions Mitral valve repair for patients with mitral regurgitation caused by infective endocarditis is safe and reliable, and the short-term effect is satisfactory. However, infection tissue should be eliminated thoroughly, and the related complications of valve replacement can be avoided and the risk of anticoagulation can be reduced.