Key result
Minimally invasive mitral valve surgery for endocarditis links to 7% in-hospital mortality without wound infections.
Why the study?
Does minimally invasive mitral valve surgery result in acceptable perioperative morbidity and mortality in patients with mitral valve endocarditis?
Observational (n=44)
No
Does minimally invasive mitral valve surgery result in acceptable perioperative morbidity and mortality in patients with mitral valve endocarditis?
Minimally invasive mitral valve surgery is a feasible approach for mitral valve endocarditis, demonstrating acceptable in-hospital mortality and low perioperative morbidity.
May support feasibility in selected cases; leaves open randomized comparison to sternotomy.
Background To minimize the surgical damage, minimally invasive mitral valve surgery (MIMVS) has become the therapy of choice. However, this approach is technically more challenging, especially in endocarditis. The data on MIMVS in endocarditis are scarce, we therefore retrospectively analyzed the result at our institute. Methods From January 2011 and July 2017, 420 MIMVS were performed, out of which 44 (10%) were for endocarditis. Mean age was 55 ± 17 years and 41% (n = 18) were male. Results Euroscore II was 7.3 (range: 2–38). Operation times, cardiopulmonary bypass times, and clamp times were 230 (±77), 158 (±56), and 84 (±39) minutes, respectively. Seven cases (16%) were cardiac redo operations. Mitral valve repair and replacement was performed in 46 (n = 20) and 54% (n = 24) of patients, respectively. Overall in-hospital mortality, apoplexy, and reoperation rates (all for bleeding) were 7 (n = 3), 0 (n = 0), and 11% (n = 5), respectively. New onset of dialysis was required in three patients (7%). No patient developed superficial wound infection. Overall intensive care unit and hospital stay was 3 (±3) and 24 (±32) days, respectively. Conclusion MIMVS can be performed with acceptable outcome and low perioperative morbidity in patients with mitral valve endocarditis. Especially absence of any postoperative wound infections and low rate of endocarditis recurrence; use of MIMVS must be encouraged as an eligible approach in most cases.
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Fleißner et al. (2018) conducted an observational in Mitral valve endocarditis (n=44). Minimally invasive mitral valve surgery (MIMVS) was evaluated on In-hospital mortality. Minimally invasive mitral valve surgery for endocarditis was associated with a 7% in-hospital mortality rate and no superficial wound infections.