{"title":"活动性感染性心内膜炎二尖瓣修复术的手术时机和可行性。","authors":"Tadashi Omoto, Atsushi Aoki, Kazuto Maruta, Tomoaki Masuda","doi":"10.5761/atcs.oa.22-00135","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>We studied the association between operative timing and the feasibility of mitral valve (MV) repair in active infective endocarditis (IE).</p><p><strong>Methods: </strong>Forty-nine active IE patients who underwent MV operation were classified according to operative timing: within 48 hours (Term I: n = 7), between 3 and 14 days (Term II: n = 22), and ≥15 days (Term III: n = 20). Patient profiles, operative outcomes, and feasibility of MV repair were evaluated. Complexity score and severity score were used to define the feasibility of MV repair depending on the extent of infected lesion and technical difficulties.</p><p><strong>Results: </strong>There were no differences in basic profile in the three groups. Rate of major complications was higher in Term I (86%) than II (41%, p = 0.031) and III (25%, p = 0.005). In-hospital mortality was also higher in Term I (43%) than II (9%, p = 0.039) and III (5%, p = 0.015). The three groups did not differ by feasibility of MV repair calculated by the two-score system or by frequency of MV repair (I: 57%, II: 59%, and III: 55%).</p><p><strong>Conclusions: </strong>Morbidity and mortality were high in urgent cases. Feasibility of MV repair is associated with the extent of infected lesion and technical difficulties, and not with operative timing.</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/4a/atcs-29-023.PMC9939675.pdf","citationCount":"0","resultStr":"{\"title\":\"Operative Timing and Feasibility of Mitral Valve Repair in Active Infective Endocarditis.\",\"authors\":\"Tadashi Omoto, Atsushi Aoki, Kazuto Maruta, Tomoaki Masuda\",\"doi\":\"10.5761/atcs.oa.22-00135\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>We studied the association between operative timing and the feasibility of mitral valve (MV) repair in active infective endocarditis (IE).</p><p><strong>Methods: </strong>Forty-nine active IE patients who underwent MV operation were classified according to operative timing: within 48 hours (Term I: n = 7), between 3 and 14 days (Term II: n = 22), and ≥15 days (Term III: n = 20). Patient profiles, operative outcomes, and feasibility of MV repair were evaluated. Complexity score and severity score were used to define the feasibility of MV repair depending on the extent of infected lesion and technical difficulties.</p><p><strong>Results: </strong>There were no differences in basic profile in the three groups. Rate of major complications was higher in Term I (86%) than II (41%, p = 0.031) and III (25%, p = 0.005). In-hospital mortality was also higher in Term I (43%) than II (9%, p = 0.039) and III (5%, p = 0.015). The three groups did not differ by feasibility of MV repair calculated by the two-score system or by frequency of MV repair (I: 57%, II: 59%, and III: 55%).</p><p><strong>Conclusions: </strong>Morbidity and mortality were high in urgent cases. Feasibility of MV repair is associated with the extent of infected lesion and technical difficulties, and not with operative timing.</p>\",\"PeriodicalId\":8037,\"journal\":{\"name\":\"Annals of Thoracic and Cardiovascular Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2023-02-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/4a/atcs-29-023.PMC9939675.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Thoracic and Cardiovascular Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5761/atcs.oa.22-00135\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/11/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Thoracic and Cardiovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5761/atcs.oa.22-00135","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/11/3 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Operative Timing and Feasibility of Mitral Valve Repair in Active Infective Endocarditis.
Purpose: We studied the association between operative timing and the feasibility of mitral valve (MV) repair in active infective endocarditis (IE).
Methods: Forty-nine active IE patients who underwent MV operation were classified according to operative timing: within 48 hours (Term I: n = 7), between 3 and 14 days (Term II: n = 22), and ≥15 days (Term III: n = 20). Patient profiles, operative outcomes, and feasibility of MV repair were evaluated. Complexity score and severity score were used to define the feasibility of MV repair depending on the extent of infected lesion and technical difficulties.
Results: There were no differences in basic profile in the three groups. Rate of major complications was higher in Term I (86%) than II (41%, p = 0.031) and III (25%, p = 0.005). In-hospital mortality was also higher in Term I (43%) than II (9%, p = 0.039) and III (5%, p = 0.015). The three groups did not differ by feasibility of MV repair calculated by the two-score system or by frequency of MV repair (I: 57%, II: 59%, and III: 55%).
Conclusions: Morbidity and mortality were high in urgent cases. Feasibility of MV repair is associated with the extent of infected lesion and technical difficulties, and not with operative timing.