Clinical application of minimally invasive mitral valvuloplasty in patients with infective endocarditis complicated with mitral valve insufficiency
- VernacularTitle:微创二尖瓣成形术在感染性心内膜炎合并二尖瓣关闭不全中的临床应用
- Author:
Yubin ZHONG
1
;
Yunqing SHI
2
;
Quanlin YANG
1
;
Songyi QIAN
1
;
Limin XIA
2
;
Kai SONG
2
;
Sun PAN
1
,
2
Author Information
1. Department of Cardiovascular Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, 361015, Fujian, P. R. China
2. Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University/Shanghai Cardiovascular Disease Institute, Shanghai, 200032, P. R. China
- Publication Type:Journal Article
- Keywords:
Infective endocarditis;
mitral valvuloplasty;
minimally invasive surgery;
mid- to long-term outcomes;
analysis of influencing factors
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2026;33(05):778-783
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of minimally invasive mitral valvuloplasty (MVP) in the treatment of infective endocarditis (IE) with mitral regurgitation (MR). Methods A retrospective analysis was conducted on the clinical data of patients who underwent MVP for IE with MR at the Department of Cardiovascular Surgery in Zhongshan Hospital, Fudan University from 2016 to 2020. Patients were divided into two groups based on the surgical incision: those with a right mini-thoracotomy were classified as a minimally invasive surgery (MIS) group, and those with a median sternotomy (MS) were classified as an MS group. All patients had isolated mitral valve involvement. Perioperative data were analyzed, and mid- to long-term outcomes were compared between the two groups. Results A total of 86 patients were included, with 40 in the MIS group [22 males and 18 females, with a mean age of (39.78±15.36) years ranging from 14 to 75 years] and 46 in the MS group [27 males and 19 females, with a mean age of (49.94±16.13) years ranging from 14 to 71 years]. The patients in the MIS group were relatively younger (P=0.004) with better preoperative cardiac function (P=0.004). There was no statistical difference in preoperative fever, gender, or comorbidities between the two groups (P>0.05). The MIS group had shorter postoperative ventilation times, less postoperative 24-hour drainage, less blood transfusion, and shorter total hospital stays compared to the MS group (P＜0.05). There was no statistical difference in cardiopulmonary bypass times or ICU stays between the two groups (P>0.05). The perioperative complication rates and mortality rates were not significantly different between the two groups (P>0.05). Follow-up was conducted for 11-92 months, with a mean duration of (49±19) months and an overall follow-up rate of 91.9%. During the follow-up, 3 patients in each group required reoperation for mitral valve issues, with no statistical difference in incidence (7.5% vs. 6.5%, P=0.691). There were no warfarin-related complications, recurrences, or deaths in either group during follow-up. Multivariate regression analysis identified age, preoperative cardiac function, and surgeon experience as influencing factors for the choice of surgical approach. Conclusion Minimally invasive MVP for IE with MR is relatively safe in the perioperative period and shows significant efficacy, with clear mid- to long-term outcomes. It is recommended for younger patients with better preoperative cardiac function and when performed by surgeons with extensive experience in mitral valvuloplasty.
