Abstract:
We describe successful treatment, including valve repair for mitral
endocarditis. A 9 year-old boy presented with weakness and
high fever. Despite 2 weeks of antibiotics at the local hospital
infectious signs persisted. To determine the cause of the fever, he
was admitted to our hospital. Transesophageal echocardiography
(TEE) revealed severe mitral regurgitation; posterior leaflet was
perforated and very large mobile vegetation was spread on the
posterior wall of the left atrium. Abscess formation was visible
beyond the posterior leaflet. Staphylococcus aureus was isolated
from blood cultures. Intra-operatively, the patient underwent
abscess debridement followed by reconstruction of the mitral
annulus with fresh autologous pericardial patch. Mitral repair was
achieved by quadrangular resection of the posterior mitral valve
leaflet, retention of the primary and secondary chordae. Body of
the posterior valve leaflet was reconstructed using fresh autologous
pericardium. The constructed posterior valve was implanted on
the edge of the sutured annular patch. Antibiotic therapy was
continued for 6 weeks after surgery, and infections did not
reoccur. The postoperative course was uneventfull and follow-up
echocardiography showed minimally regurgitation of the mitral
valve.
