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New York City Conference

Back to 2014 Annual Meeting Abstracts


Degenerative Mitral Valve Repair: Presentation with Endocarditis Does Not Affect Long-term Results
Dan Spiegelstein, Dan Loberman, Michael Stein, Maor Yasmin, Leonid Sternik, Alexander Kogan, Micha S. Feinberg, Ehud Raanani.
Chaim Sheba Medical Center, Ramat Gan, Israel.

OBJECTIVE:
While the advantages of mitral valve repair over replacement are well documented for degenerative myxomatous disease, the comparative long-term clinical and echocardiographic outcome of degenerative mitral valve repair in patients with endocarditis is yet to be established.
METHODS: From 2004 to date, 555 patients with degenerative mitral valve underwent repair in our department. Of them, 43 (8%) (SBE) presented for surgical repair: 27 with acute, 6 with sub-acute and 10 with healed mitral valve endocarditis. Their results were compared with the remaining 512 patients with degenerative mitral valve (non-SBE) who presented with other clinical manifestations. We prospectively followed all patients and analyzed outcomes regarding clinical improvement and echocardiography results.

RESULTS: There were no in-hospital deaths in SBE, and 2 in the non-SBE group (NS). Follow-up ranged to 9.2 years with a mean of 34±28 months and 27±26 months in SBE and non-SBE, respectively. Late all-cause mortality was 7% (3 patients) in SBE versus 2% (10 patients) in non-SBE (p=0.14). Freedom from re-operation on the mitral valve was 95% (2 patients) and 96% (21 patients) in SBE and non-SBE, respectively (p=0.7). Freedom from recurrent endocarditis was 100% in the SBE group. Late echocardiography revealed that 95% and 91% of patients in SBE and non-SBE, respectively were free from moderate to severe mitral regurgitation (p=0.6). Freedom from NYHA FC III-IV was 94% and 88% in SBE and non-SBE, respectively (p=0.02). All other late valve-related complications were similar in both groups.
CONCLUSIONS: Degenerative mitral valve repair presenting with infective endocarditis has similar mid- to long-term clinical and echocardiographic outcomes compared with non-endocarditis degenerative mitral valve. Recurrent SBE is rare.
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