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You are here: Contents > 2006 > Volume 15 Number 3 May 2006 > MITRAL VALVE DISEASE > Management of Commissural Lesions in Native Mitral Valve Endocarditis: Long-Term Results of Valve Repair and Partial Homograft Replacement

Management of Commissural Lesions in Native Mitral Valve Endocarditis: Long-Term Results of Valve Repair and Partial Homograft Replacement

Rachid Zegdi1,2, Ziad Khabbaz2, Erwan Flecher2, Christian Latrémouille1,2, Milena Noghin2, 

Sylvain Chauvaud2, Jean Gerota3, Alain Deloche1,2, Alain Carpentier1,2, Jean-Noël Fabiani1,2
1Université René Descartes, Paris V, 2Service de Chirurgie Cardiovasculaire, Hôpital Européen Georges Pompidou, Paris, 3Banque de Tissu Humain, Hôpital Saint-Louis, Paris, France

Background and aim of the study: Commissural lesions in the context of native mitral valve endocarditis are a technically challenging condition for conservative surgery. Herein are reported the authors’ 10-year results for mitral valve repair (MVRep) or partial homograft replacement (PHR) performed in this setting.
Methods: Data were reviewed from 19 consecutive patients who underwent MVRep using either Carpentier’s technique (n = 14) or PHR (n = 5) for endocarditis at the authors’ institution between 1989 and 1994.
Results: There was one operative death (5%; 95% CI 0-15.5%). Two reoperations were performed in each subgroup for recurrence of endocarditis (n = 2) and



mitral valve failure (n = 2). The 10-year survival rate and freedom from mitral valve reoperation were 95% (95% CI 84-100%) and 78% (95% CI 59-97%), respectively. At 10 years, 13 (93%) surviving and non-reoperated patients were in good functional status (NYHA class I-II), and 14 (100%) were in sinus rhythm. Although echocardiographic results were excellent in the MVRep group, all PHR patients had moderate or severe mitral valve dysfunction.
Conclusion: Commissural reconstruction using Carpentier’s techniques demonstrated excellent long-term results in patients with native mitral valve endocarditis. In contrast, the results for PHR were rather disappointing.
The Journal of Heart Valve Disease 2006;15:356-359

Management of Commissural Lesions in Native Mitral Valve Endocarditis: Long-Term Results of Valve Repair and Partial Homograft Replacement

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