Project description:Infective endocarditis (IE) rarely results in mitral stenosis (MS), but MS in patients with IE can be life-threatening. We present a case of prosthetic MS secondary to IE. A 69-year-old Japanese man underwent mitral valve replacement with a bioprosthetic valve 2 years previously. The patient presented with a 1-month history of illness, and we diagnosed prosthetic valve IE with severe MS and planned for time-sensitive surgery. However, the patient developed cardiogenic shock in response to prosthetic mitral valve obstruction while awaiting surgery. The patient then had to undergo emergency surgery. There are no management guidelines for IE-induced valve stenosis, whose treatment differs from that of valve regurgitation. Our literature review reveals that achieving survival in patients with MS secondary to IE is difficult without surgical intervention. Patients with MS caused by IE may require surgery, and specific criteria should be outlined in future guidelines.

| S-EPMC11646871 | biostudies-literature

Longitudinal Outcomes Following Mitral Valve Repair for Infective Endocarditis.

Project description:Mitral valve repair is the ideal approach in managing mitral valve infective endocarditis for patients requiring surgery. However, viable repair is influenced by the extent of valve destruction and there can be technical challenges in reconstruction following debridement. Overall, data describing long-term outcomes following mitral repair of infective endocarditis are scarce. We, therefore, assessed the late outcomes of 101 consecutive patients who underwent mitral valve repair for IE at the University of Ottawa Heart Institute from 2001 to 2021. The 5- and 10-year survival rate was 80.8 ± 4.7% and 61.2 ± 9.2%, respectively. Among these 101 patients, 7 ultimately required mitral valve reoperation at a median of 5 years after their initial operation. These patients were of a mean age of 35.9 ± 7.3 years (range 22-44 years) at the time of their initial operation. The 5- and 10-year freedom from mitral valve reoperation was 93.6 ± 3.4% and 87.7 ± 5.2%, respectively. Overall, mitral valve repair can be an effective method for treating infective endocarditis with a favourable freedom from reoperation and mortality over the long term.

| S-EPMC11434133 | biostudies-literature

Bicuspid reconstruction surgery in a patient suffering from aortic valve infective endocarditis with annular abscess using Ozaki's procedure: A case report.

Project description:IntroductionAortic valve infective endocarditis with annular abscess is associated with high mortality rate and surgery is usually the choice of treatment. Plasty or reconstruction of aortic valve is being performed more widely.Presentation of caseWe report a case study of a 56-year-old male who was diagnosed with congenital bicuspid aortic valve, severe aortic stenosis and regurgitation, and annular abscess. This patient underwent operation in december 2019 and Ozaki's procedure was used to measure the distance between two commissures to reconstruct new leaflets and close the abscess using autologous pericardium. A bicuspid valve was reconstructed based on the anatomical feature of the patient. 6 months after surgery, aortic valve function was good with no residual insufficiency, maximum gradient was 8 mmHg.DiscussionReconstruction of aortic valve by Ozaki's procedure has been reported with many advantages for the patient. In case of infectious endocarditis, this technique helps avoid the use of artificial materials. Bicuspid aortic valve reconstruction surgery following the novel methods of reconstructing three leaflets or maintaining the bicuspid morphology could both be performed with good results.ConclusionReconstruction of aortic valve by Ozaki's procedure in infectious endocarditis has good results. In case of true bicuspid aortic valve, reconstruction bi-leaflets can be performed.

| S-EPMC7566199 | biostudies-literature

Limited versus Radical Resection in Mitral Valve Infective Endocarditis Surgery.

Project description:Background: Mitral valve repair is preferred in patients undergoing surgical treatment for infective endocarditis (IE) of the native mitral valve, however, radical resection of infected tissue and patch-plasty might potentially lead to low or non-durable repair. We aimed to compare a limited-resection and non-patch technique with the classic radical-resection technique. Methods: Eligible candidates were patients with definitive IE of the native mitral valve undergoing surgery between January 2013 and December 2018. Patients were classified according to the surgical strategy into two groups: limited- versus radical-resection strategy. Propensity score matching was used. Endpoints were repair rate, all-cause mortality (30-day and 2-year), re-endocarditis and reoperation at q-year follow-up. Results: After propensity score matching, 90 patients were included. Follow-up was 100% complete. Mitral valve repair rate was 84% in the limited-resection versus 18% in the radical-resection strategy, p < 0.001. The 30-day and 2-year mortality were 20% versus 13% (p = 0.396) and 33% versus 27% (p = 0.490) in the limited-resection versus radical-resection strategy, respectively. The incidence of re-endocarditis during the 2-year follow-up was 4% in the limited-resection strategy versus 9% in the radical-resection strategy, p = 0.677. Three patients in the limited-resection strategy underwent reoperation of the mitral valve, while there were none in the radical-resection strategy (p = 0.242). Conclusions: Although mortality in patients with IE of the native mitral valve remains high, the limited-resection and non-patch surgical strategy is associated with a significantly higher repair rates with comparable 30-day and mid-term mortality, risk of re-endocarditis and re-operation compared to the radical-resection strategy.

| S-EPMC10144351 | biostudies-literature

Ruptured mitral valve abscess with mitral incompetence in culture negative infective endocarditis: case report.

Project description:IntroductionPerivalvular abscess in native valve infective endocarditis (IE) is associated with significantly increased mortality.Case descriptionHerein, we report a 29 year old Indian male who presented with culture negative IE with perivalvular abscess and severe mitral regurgitation requiring mitral valve replacement.DiscussionInitial approach is very difficult in terms of when IE presents as culture negative. This case highlights the important role of echocardiography in the management of culture negative IE.

| S-EPMC6426010 | biostudies-literature

Hypoxemia Requiring Venovenous Extracorporeal Membrane Oxygenation after Tricuspid Valvulectomy for Infective Endocarditis.

Project description: Not available

| S-EPMC6710821 | biostudies-literature

Infective Endocarditis Complicated with Anterior Mitral Leaflet Abscess: A Case Report.

Project description:Infective endocarditis (IE) is defined as infection of endocardial surface of the heart. It may include one or more heart valves, the mural endocardium or a septal defect. Its intracardiac effect includes severe valvular insufficiency which may lead to intractable congestive heart failure and myocardial abscess. Infective endocarditis especially complicated by an abscess is associated with high mortality, despite the medical and surgical therapeutic options available. Surgical intervention is indicated in cases of heart failure or uncontrolled infection and sometimes for the prevention of embolic phenomena. We report a case of 42 yrs/M with RVHD admitted in Dr D.Y.Patil hospital, Kolhapur. He had high grade, continuous fever, vomiting, cough with expectoration since 15 days prior to admission. He had prior embolic stroke 2 months back from which he recovered completely. The diagnosis of Infective endocarditis was confirmed clinically & echocardiographically by Duke's criteria. His ECHO showed severe MR, Moderate MS and large vegetations on AML oscillating through mitral orifice along with subvalval (mitral) abscess. Due to severe haematemesis following Mallory weiss tear surgical intervention was not possible. Patient succumbed as a result of refractory pulmonary oedema.

| S-EPMC5353443 | biostudies-literature

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