Samuel R. Schnittman, MD, David H. Adams, MD, Shinobu Itagaki, MD, Nana Toyoda, MD, Natalia N. Egorova, PhD, Joanna Chikwe, MD
Consensus guidelines recommend repair over replacement for the surgical treatment of active native mitral valve infective endocarditis. However, contemporary practice and long-term outcome data are limited.
Multivariable Cox regression was used to compare outcomes of 1970 patients undergoing isolated primary mitral valve repair (n = 367, 19%) or replacement (n = 1603, 81%) for active infective endocarditis between 1998 and 2010 in New York and California states. The primary outcome was long-term survival. Secondary outcomes were recurrent endocarditis and mitral reoperation. Median follow-up time was 6.6 years (range 0-12), and last follow-up date was December 31, 2015.
In active endocarditis, mitral valve repair is associated with better survival and lower risk of recurrent infection compared with valve replacement and should be the surgery of choice when feasible.
- Andrea Colli, MD, David Adams, MD, Alessandro Fiocco, MD, Nicola Pradegan, MD, Lorenzo Longinotti, MD, Matteo Nadali, MD, Dimosthenis Pandis, MD, Gino Gerosa, MD
- Ahmed El-Eshmawi, MD, Dimosthenis Pandis, MD, David H. Adams, MD, Gilbert H. Tang, MD
- Ahmed El-Eshmawi, MD, Javier G. Castillo, MD, David H. Adams, MD
- Joanna Chikwe, MD, Eugene H. Blackstone, MD, David H. Adams, MD