Feasibility and outcome of mitral valve repair in patients with infective endocarditis
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Key result
Mitral valve repair in patients with infective endocarditis resulted in a 3-year mortality rate of 26% compared to 36% for valve replacement, though the difference was not statistically significant (p=0.86).
Why the study?
Valve repair is standard for native mitral regurgitation, but its feasibility when caused by acute infective endocarditis is debated.
Does mitral valve repair improve mortality and freedom from recurrent endocarditis compared to mitral valve replacement in patients with native mitral valve infective endocarditis?
Population
108 patients with native mitral IE potentially eligible for surgical repair
Comparison
Valve repair vs valve replacement
Design
Single-center retrospective study
Follow-up
Mean 3 years
Authors
Discussion
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Implication
Repair yields comparable mid-term outcomes to replacement in this cohort; leaves open randomized confirmation of benefit in native mitral endocarditis.
Study Design
Type
Cohort (n=90)
Multicenter
No
Structured PICO
Does mitral valve repair improve mortality and freedom from recurrent endocarditis compared to mitral valve replacement in patients with native mitral valve infective endocarditis?
P
Population
90 patients with native mitral valve infective endocarditis undergoing surgical treatment, followed for a mean of 3 years.
I
Intervention
Mitral valve repair
C
Comparator
Mitral valve replacement
O
Outcome
Mortality and freedom from recurrent endocarditis at mean 3 years follow-uphard clinical
Main Result
Absolute Event Rate: 26% vs 36%
p-value: p=0.86
Mitral valve repair for infective endocarditis is feasible and yields comparable mid-term mortality and relapse rates to valve replacement, supporting its use when anatomically possible.
Limitations
- Retrospective nature of the study
- Single-center experience
- Relatively small cohort size
- Selection bias due to lack of pre-specified criteria for repair, relying on expert consensus and intraoperative inspection
- Retrospective nature
- Relatively small cohort
- Lack of pre-specified criteria for repair (selection bias)
Cite This Study
Scheggi et al. (2020) conducted a cohort in Native mitral valve infective endocarditis (n=90). Mitral valve repair vs. Mitral valve replacement was evaluated on All-cause long-term (3 years) mortality (p=0.86). Mitral valve repair in patients with infective endocarditis resulted in a 3-year mortality rate of 26% compared to 36% for valve replacement, though the difference was not statistically significant (p=0.86).
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