Mitral Valve Repair vs. Replacement in Infective Endocarditis.
Summary: Mitral Valve Repair vs. Replacement in Infective Endocarditis.
Published online: March 18, 2025/ The American Journalof Cardiology, .
Meta-analysis of 21 studies comparing mitral valve (MV) repair and MV replacement in patients with infective endocarditis (IE). The analysis included 4,607 patients, with 36.3% undergoing MV repair and 63.7% undergoing MV replacement, and follow-up extending up to 16 years.
Key Findings:
1. Long-term Mortality: MV repair was associated with significantly better long-term survival rates compared to MV replacement, as confirmed by three statistical tests (Logrank, Breslow, and Tarone-Ware).
2. Recurrence of IE: Recurrence of IE was significantly less likely after MV repair than after MV replacement.
3. Reoperation Rates: Freedom from reoperation was similar for both MV repair and replacement.
While MV repair is proven to be a safe and effective long-term option, especially in terms of IE recurrence and survival, current trends often favor replacement, particularly in active endocarditis. However, the study acknowledges that not all patients are candidates for repair and may require replacement.