Reparación valvular en la endocarditis mitral

Abstract

IntroductionInfective endocarditis (IE) is a pathology with a high morbidity and mortality rate and represents a growing public health problem. Surgical treatment is necessary in more than half of the cases, 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 methodsThe 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. ResultsThe 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 interposition and/or Goretex® 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 treatment of IE, providing significant benefits compared to valve replacement. ConclusionThe evaluated surgical results suggest that mitral repair surgery should be considered the procedure of choice for the surgical treatment of IE, whenever technically feasible.