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Surgical Techniques for Treatment of Bacterial Endocarditis of the Mitral Valve
Author(s) -
CACHERA JEANPAUL,
LOISANCE D.,
MOURTADA A.,
CASTANIÉ J.B.,
HEURTEMATTE Y.
Publication year - 1987
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1987.tb00182.x
Subject(s) - medicine , mitral valve , endocarditis , mitral valve repair , cardiology , infective endocarditis , abscess , mitral regurgitation , surgery , chordae tendineae
Bacterial endocarditis of the mitral valve appears to be much less common than bacterial endocarditis of the aortic valve. One of the main etiologic factors is the presence of degenerative lesions of the mitral apparatus, ballooning or mitral floppy valve. The surgical anatomy of the lesions is described: vegetations, perforations, rupture of chordae tendinae, abscess of the mitral ring observed in the isolated mitral endocarditis, mitral‐aortic dislocation, abscesses and aneurysms of the mitral‐aortic fibrosa and jet lesions on the anterior mitral leaflet. In the isolated primitive mitral infective lesions, all the technical skills are directed toward the prevention of the perivalvular leakage of the prostheses. Special procedures are described for the management of the ascesses of the mitral ring. In patients with mitral‐aortic lesions, the main problem is treatment of the dislocation of the annuli or aneurysms of the mitral‐aortic fibrosa. Despite technical advances, the surgical prognosis of the mitral endocarditis remains severe. In a personal series, the authors recorded a mortality of 12% in isolated mitral cases and 42% in the combined mitral‐aortic patients. Early surgical treatment remains the most significant factor in decreasing the fatality of such lesions.