Successful mitral valve reconstruction using autologous pericardium in a pregnant patient with severe infective endocarditis: a case report

Fig. 1. Preoperative echocardiographic findings. Echocardiography showed a 17-mm mobile mass at the posteromedial commissure mitral valve (A) and associated severe mitral regurgitation (B). Three-dimensional echocardiography revealed vegetation (arrow) on the mitral valve’s posteromedial site (C)

Fig. 2. Intraoperative findings. A vegetation was attached to the mitral valve’s posteromedial leaflet on the ventricular side, extending from A3 to P3, with associated chordae tendineae rupture and leaflet prolapse (A). The annulus remained intact. Fixed autologous pericardium was shaped into a pentagonal patch (B). After the infected tissue was resected, a defect involving the A3–P3 region and commissure was created. The pericardial patch’s apical end was sutured to the posterior papillary muscle, and the lateral side was sutured to the resected mitral leaflet and mitral annulus (C). Water irrigation testing revealed no signs of mitral regurgitation and confirmed optimal valve geometry (D). Vegetation was observed on the left ventricular side of the excised mitral valve leaflet tissue (E)

Fig. 3. Postoperative echocardiography findings. Postoperative transesophageal echocardiography demonstrated successful mitral valve repair using the autologous pericardial patch (A), with no mitral regurgitation noted (B). The valve leaflets exhibited adequate coaptation during systole (C)