Mitral valve replacement after application of atrial appendix flap in endocarditis with posterior annular abscess.

In patients with acute bacterial endocarditis and annular abscess formation, cardiac valve replacement is associated with high perioperative mortality and morbidity. We present two patients who had had infective endocarditis and annular abscess formation in the mural leaflet region. Before replacing the mitral valve, we covered the atrium and annulus with a flap of evaginated left atrial appendix.