Valve repair in mitral endocarditis

Introduction: Infective endocarditis (IE) is a pathology with a high morbidity and mortality rate andrepresents a growing public health problem. Surgical treatment is necessary in more than half of thecases, and its main purpose is to completely remove the infected tissue and reconstruct normal cardiac anatomy, including repair or replacement of the affected valve(s). Objectives and methods: The present study focuses on describing the most appropriate procedure for mitral repair surgery in cases of IE, based on the literature and the extensive experience gained by the surgical team. Likewise, we have compiled through a systematic search of the literature the results that have been reported on reparative surgery compared to mitral valve replacement. Results: The surgical technique described requires a thorough study of the degree of involvement and destructuring of the different valve segments. We consider resection with pericardial patch interpositionand/ or Goretex((R)) neochord implantation to be the standard technique that allows reproducible results. The structured review of the available scientific evidence verifies the safety of mitral repair for the treatmentof IE, providing significant benefits compared to valve replacement. Conclusion: The evaluated surgical results suggest that mitral repair surgery should be considered the procedure of choice for the surgical treatment of IE, whenever technically feasible. (c) 2022 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Cirugia Cardiovascular yEndovascular. This is an open access article under the CC BY-NC-ND license (http://creativecommons. org/licenses/by-nc-nd/4.0/).