Minimally Invasive Surgery in Mitral Valve Endocarditis

Felix Fleißner; Jawad Salman; Jamshid Naqizadah; Murat Avsar; Julia Meier; Gregor Warnecke; Christian Kühn; Serghei Cebotari; Stefan Ziesing; Axel Haverich; Igor Tudorache

doi:10.1055/s-0038-1675342

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2019; 67(08): 637-643
DOI: 10.1055/s-0038-1675342

Original Cardiovascular

Georg Thieme Verlag KG Stuttgart · New York

Minimally Invasive Surgery in Mitral Valve Endocarditis

Felix Fleißner

¹Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

²Institute for Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany

,

Jawad Salman

¹Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

,

Jamshid Naqizadah

¹Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

,

Murat Avsar

¹Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

,

Julia Meier

¹Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

,

Gregor Warnecke

¹Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

,

Christian Kühn

¹Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

,

Serghei Cebotari

¹Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

,

Stefan Ziesing

³Instiute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany

,

Axel Haverich

¹Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

,

Igor Tudorache

¹Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

› Author Affiliations

Abstract

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Abstract

Background To minimize the surgical damage, minimally invasive mitral valve surgery (MIMVS) has become the therapy of choice. However, this approach is technically more challenging, especially in endocarditis. The data on MIMVS in endocarditis are scarce, we therefore retrospectively analyzed the result at our institute.

Methods From January 2011 and July 2017, 420 MIMVS were performed, out of which 44 (10%) were for endocarditis. Mean age was 55 ± 17 years and 41% (n = 18) were male.

Results Euroscore II was 7.3 (range: 2–38). Operation times, cardiopulmonary bypass times, and clamp times were 230 (±77), 158 (±56), and 84 (±39) minutes, respectively. Seven cases (16%) were cardiac redo operations. Mitral valve repair and replacement was performed in 46 (n = 20) and 54% (n = 24) of patients, respectively. Overall in-hospital mortality, apoplexy, and reoperation rates (all for bleeding) were 7 (n = 3), 0 (n = 0), and 11% (n = 5), respectively. New onset of dialysis was required in three patients (7%). No patient developed superficial wound infection. Overall intensive care unit and hospital stay was 3 (±3) and 24 (±32) days, respectively.

Conclusion MIMVS can be performed with acceptable outcome and low perioperative morbidity in patients with mitral valve endocarditis. Especially absence of any postoperative wound infections and low rate of endocarditis recurrence; use of MIMVS must be encouraged as an eligible approach in most cases.

Keywords

minimally invasive surgery - mitral valve surgery - endocarditis

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References

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