Native Infective Mitral Valve Endocarditis

In our Institution, 46 patients (51% male and 49% female) underwent surgical treatment for isolated native infective mitral valve endocarditis from 1969 to 1996. Age ranged from 7 to 74 years with a mean of 40 years. The isolated bacteria were Streptococcus (68%) and Staphylococcus aureus (21%). Pre-existent mitral disease was found in 11 patients (mitral prolapse of the posterior leaflet or rheumatic fever). Antibiotic therapy ranged from 1 to 6 weeks preoperatively and 2 to 8 weeks postoperatively. Indications for surgery were: congestive heart failure, uncontrolled sepsis, threatening vegetations on echocardiographic examination and peripheral or cerebral emboli. The delay between diagnosis and surgery was 1-6 weeks. Surgical valve replacement was performed in 44 patients (29 ball cages, seven xenografts, three monoleaflet and five bileaflet) and two mitral valve repairs (ring anuloplasty) in two patients. Surgical management of the lesion consisted of extensive debridement followed by either simple repairof defects or complex reconstructions involving pericardial, synthetic patches or more complex reconstructions...