ArticleThe Journal of thoracic and cardiovascular surgery2024
Isolated mitral valve endocarditis: Patient, disease, and surgical factors that influence outcomes.
Article in The Journal of thoracic and cardiovascular surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Long-Term Outcomes of Mitral Valve Repair with Limited Resection in Active Endocarditis.Journal of cardiovascular development and disease · 2026Article
- Minimally Invasive Surgery for Mitral Valve Endocarditis: A Systematic Review and Meta-Analysis of Reconstructed Time-to-Event Data.Journal of personalized medicine · 2026Review
- Repair Versus Replacement in Mitral Valve Endocarditis Due to Methicillin-SusceptiblePathogens (Basel, Switzerland) · 2025Article
- Advancements and Challenges in the Management of Prosthetic Valve Endocarditis: A Review.Pathogens (Basel, Switzerland) · 2024Review
- Native Infective Endocarditis: A State-of-the-Art-Review.Microorganisms · 2024Review
- Surgery for Active Infective Endocarditis on Mitral Valve: Anatomical, Surgical, and Disease Factors as Long-Term Outcome Modifiers.Medicina (Kaunas, Lithuania) · 2024Article
- Twenty-Year Experience with Surgery for Native and Prosthetic Mitral Valve Endocarditis.Medicina (Kaunas, Lithuania) · 2023Article
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Abstract
objectiveThe objectives of this study were to investigate patient characteristics, valve pathology, bacteriology, and surgical techniques related to outcome of patients who underwent surgery for isolated native (NVE) or prosthetic (PVE) mitral valve endocarditis.
methodsFrom January 2002 to January 2020, 447 isolated mitral endocarditis operations were performed, 326 for NVE and 121 for PVE. Multivariable analysis of time-related outcomes used random forest machine learning.
resultsStaphylococcus aureus was the most common causative organism. Of 326 patients with NVE, 88 (27%) underwent standard mitral valve repair, 43 (13%) extended repair, and 195 (60%) valve replacement. Compared with NVE with standard repair, patients who underwent all other operations were older, had more comorbidities, worse cardiac function, and more invasive disease. Hospital mortality was 3.8% (n = 17); 0 (0%) after standard valve repair, 3 (7.0%) after extended repair, 8 (4.1%) after NVE replacement, and 6 (5.0%) after PVE re-replacement. Survival at 1, 5, and 10 years was 91%, 75%, and 62% after any repair and 86%, 62%, and 44% after replacement, respectively. The most important risk factor for mortality was renal failure. Risk-adjusted outcomes, including survival, were similar in all groups. Unadjusted extended repair outcomes, particularly early, were similar or worse than replacement in terms of reinfection, reintervention, regurgitation, gradient, and survival.
conclusionsA patient- and pathology-tailored approach to surgery for isolated mitral valve endocarditis has low mortality and excellent results. Apparent superiority of standard valve repair is related to patient characteristics and pathology. Renal failure is the most powerful risk factor. In case of extensive destruction, extended repair shows no benefit over replacement.
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