Báo cáo trường hợp về phẫu thuật sửa van hai lá thành công trên bệnh nhân viêm nội tâm mạc nhiễm trùng

Infective endocarditis (IE) represents a severe and life-threatening cardiac infection, frequently involving heart valves and carrying a high mortality rate. The management of IE, particularly when complicated by valvular damage, poses a significant clinical challenge due to the risk of severe complications such as heart failure and systemic embolism. Mitral valve repair (MVRp) has emerged as the preferred surgical approach for eligible patients, aiming to preserve native valve structure and functionality, thereby reducing risks associated with valve replacement. This case report highlights the crucial role of timely and effective MVRp in achieving favorable outcomes for patients presenting with severe IE, underscoring its importance in contemporary cardiac surgery.

Cardiologists, cardiac surgeons, infectious disease specialists, internal medicine physicians, and medical researchers interested in the management of valvular heart disease and infective endocarditis.

Infective endocarditis (IE) remains a formidable challenge in cardiovascular medicine, characterized by high morbidity and mortality. This clinical case report details the successful mitral valve repair (MVRp) in a 25-year-old male patient diagnosed with acute IE affecting a native mitral valve, presenting with a large vegetation and severe mitral regurgitation. The patient exhibited alarming neurological symptoms, necessitating urgent surgical intervention. The adopted surgical strategy focused on radical eradication of infected tissue and meticulous reconstruction of the valve's morphology. The procedure involved vegetectomy, precise reconstruction of the damaged posterior leaflet, and the placement of an annuloplasty ring to stabilize the valve structure. Postoperatively, the patient showed remarkable recovery, with echocardiographic assessments confirming significant improvement in mitral valve function, a substantial reduction in regurgitation from severe (4/4) to mild (1.5/4), and preserved left ventricular systolic function (LVSF). Long-term follow-up over two years further validated the durability and efficacy of the repair, with sustained functional results. This case not only underscores the technical feasibility of performing complex mitral valve repair in the context of active IE but also reinforces MVRp as a superior option to valve replacement in suitable cases, mitigating risks associated with prosthetic valves. It demonstrates that with a comprehensive surgical approach, excellent clinical and functional outcomes can be achieved, aligning with current international and national guidelines for managing IE.