1. Mitral valve repair in infective endocarditis is not inferior to valve replacement: results from a Spanish nationwide prospective registry
- Author
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Javier Bermejo, Víctor José González Ramallo, Marta Hernández-Meneses, Adrián Téllez, Víctor Asensi Álvarez, Claudia González-Rico, Vicente Climent, Luis Eduardo López-Cortés, José David Rodrigo Carbonero, Castelo-Corral Laura, Francesc Marco, Eduard Quintana, Leyre López-Soria, Pere Pericas, Pilar Martín-Dávila, Ana Fernández-Cruz, Alejandro Martin-Quiros, José Ignacio Aramendi, José A. Oteo, Roberto Blanco Mata, David Nicolás, Marina Cueto-López, Guillermo Ojeda Burgos, Marta Bodro, Esperanza Merino de Lucas, Natividad Benito, Fernando Dominguez, Jose A. Lepe, Patricia Carmen Muñoz García, Juan M Pericas, Daniel Pereda, Javier De La Torre-Lima, Omar A Araji-Tiliani, Antonia Delgado-Montero, and Asunción Moreno Camacho
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Heart Valve Diseases ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Valve replacement ,Recurrence ,Mitral valve ,medicine ,Humans ,Endocarditis ,Prospective Studies ,Registries ,Aged ,Heart Valve Prosthesis Implantation ,Mitral valve repair ,business.industry ,Mitral valve replacement ,EuroSCORE ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Survival Rate ,medicine.anatomical_structure ,030228 respiratory system ,Spain ,Cardiothoracic surgery ,Infective endocarditis ,Mitral Valve ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Introduction Infective endocarditis (IE) still carries high morbidity and mortality and frequently requires surgery. The benefit of mitral valve repair (MVr) in the setting of IE is yet to be proven. The goal of this study was to assess the results of MVr in patients with IE after a minimum follow-up of 1 year. Methods This study is based on a Spanish nationwide prospective registry that included patients operated on for native mitral valve IE. The collaborating Institutions pooled their pre-, peri-, and postoperative data into the database of the GAMES group [Grupo de Apoyo al Manejo de la EndocarditiS (Group for support and management of infective endocarditis)]. Results Data from 27 hospitals were recorded and 3524 cases of active IE identified between 2008 and 2016. There were 1513 cases of mitral IE, of which 898 involved native valves. Of these, 437 patients underwent surgical treatment, and 369 completed the 1-year follow-up. The valve was repaired in 68 cases (18.4%). Preoperative groups were comparable (EuroSCORE MVr 7.7 vs MVR 8.0; p = ns). Mortality in the repair group was inferior to that in the replacement group (16.2% vs 27.2%, p = 0.058). At 1 year, mortality remained higher in the replacement group: 3.7% vs 2.9%. Relapse of the infection was slightly more frequent in the repair group (7.1% vs 3.7%; p = ns), although this did not lead to higher rates of reintervention (MVr/MVR: 2.9% vs 4.9%). Conclusion MVr is an attractive option for specific patients with IE and does not seem to negatively impact on relapses.
- Published
- 2019
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