Introduction
Mitral valve repair is a widely accepted surgical approach for treatment of infective endocarditis of the mitral valve [1]. However, mitral valve replacement is sometimes required for profoundly extensive and destructive active infective endocarditis of the mitral valve because of the difficulty of valve reconstruction. In our hospital, extensive mitral valve reconstruction with fresh autologous pericardium and artificial chordae has been performed in such cases. This technique is used especially in young patients to avoid mechanical valve replacement, which necessitates lifelong anticoagulation with a vitamin K antagonist to prevent stroke and systemic embolization. In this procedure, it is crucial to clarify the long-term surgical outcome because the durability and future performance of the mitral leaflet after extensive reconstruction using fresh autologous pericardium have not been established. We herein report the surgical results of this procedure with a particular focus on the long-term outcome.