[Valve repair surgery in infectious endocarditis].

BACKGROUND

Valve replacement has been the treatment of choice for patients with valvular complications of infectious endocarditis (IE). However, excellent results with valve repair allowed it to become a new therapeutic alternative for these patients.

AIM: To evaluate the results of valve repair in patients with valvular complications of IE.

PATIENTS AND

METHODS

From January 1991 to December 2000, 14 patients with valvular complications of IE underwent valve repair. Mean age was 37.9 +/- 14.9.

RESULTS

New York Heart Association (NYHA) class was 2.8 +/- 0.9. IE was located in the aortic in 6 (42%), in the mitral valve in 4 (29%) and in both valves in 4 cases (29%). Surgical indication was hemodynamic in 50% of the cases, echocardiographic in 29% and septic in 21%. Five aortic valves were bicuspid, 3 mitral valves were myxomatous and the rest were normal. The most common septic lesions were vegetations and leaflet perforations. A total of 23 aortic and 21 mitral valve repair procedures were performed. There were no deaths. Only 1 patient had a surgical complication (renal failure and prolonged mechanical ventilation). Follow-up was 100% complete. There was not late mortality. One patient with bone marrow aplasia required reoperation for a new episode of IE 19 months later. At the end of the follow-up NYHA class was 1.3 +/- 0.6 and echocardiography showed a mild or absence of valve regurgitation in most patients.

CONCLUSIONS

Valve repair surgery in IE has good results, with advantages over valve replacement.