Reoperation for prosthetic mitral valve endocarditis

Prosthetic valve endocarditis is a serious complication of mitral valve replacement with a reported incidence of 0.5% per patient-year (Current therapy in thoracic and cardiovascular surgery, 2004). Similar rates of infection are found with both biological and mechanical prostheses. Symptoms of infection are often variable with the diagnosis of prosthetic mitral valve endocarditis most often based upon blood culture data and echocardiographic evidence of vegetation or valve dysfunction. Despite advances in management of the condition, mortality associated with prosthetic mitral valve endocarditis remains high. As such, an aggressive surgical approach is required. This chapter will focus on the surgical management of the condition.