Endocarditis and its effects on mitral valve
Before the discovery of antibiotics, infective endocarditis was
invariably fatal. Even with advancements in diagnosis and treatment, the
in-hospital mortality rate for infective endocarditis is still high at
20% to 25%.22 Studies have shown that early and late
mortality rates were lower and event-free survival was greater in
patients who went through mitral valve repair to treat acute
endocarditis, as compared to those who underwent mitral valve
replacement.23 There is also a lower incidence of
recurrent infections associated with mitral valve repair as compared to
mitral valve replacement.24 Therefore, patients with
mitral valve endocarditis should be offered mitral valve repair whenever
possible.23 89% of endocarditis patients who
underwent mitral valve surgery are free from re-surgery at 5 years. This
value decreases to 72% at 10 years post-operation. Patients who
received mechanical valve replacements have a higher or equal rate of
freedom from re-operation at 10 years compared with those who received
biological valve replacements.25 Native mitral valve
endocarditis is relatively responsive to antibiotic treatment, therefore
is likely to be cured pharmacologically. Prosthetic mitral valve
endocarditis is, however, linked with poorer
prognosis.26