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Abstract Background For patients with nonischemic dilated cardiomyopathy (NIDCM), the indications for and results of mitral surgery remain controversial. We reviewed a strategy of mitral repair and replacement for clinically relevant secondary mitral regurgitation (MR) in patients with NIDCM. Methods We retrospectively reviewed 65 patients with advanced NIDCM (LVEF

Adjunctive oral antibiotics following intravenous antibiotics are administered after valve surgery in some patients with active infective endocarditis (IE); however, little is known about their efficacy. Therefore, we evaluated the effect of adjunctive antibiotic oral therapy after IE surgeries. Between 2009 and 2017, 585 patients underwent valve surgery for left-sided active IE at 14 hospitals. Patients who died during hospitalization or transferred with intravenous antibiotics were excluded. Of the remaining 460 patients, 239 were treated with oral antibiotics at discharge (group O) and 221 did not take the oral antibiotic (group N). The primary outcome was all-cause mortality. Secondary outcomes were the recurrence of IE and a subset analysis of it. The 2 groups had similar background, postoperative inflammatory responses, and an almost similar duration of postoperative intravenous antibiotics. The overall survival rates at 1 and 5 years were 96% and 88% in group O and 92% and 84% in group N, respectively (P = 0.425). The rates of freedom from the recurrence of endocarditis at 1 and 5 years were 98% and 94% in group O and 97% and 93% in group N, respectively (P = 0.309). In chronic hemodialysis patients, the rates of freedom from the recurrence were significantly higher in group O than in group N (1 year: 100% vs 87.5%; 5 years: 95% vs 69%, P = 0.022). Adjunctive oral antibiotics following intravenous antibiotics in patients with active IE after valve surgery did not affect the overall survival and recurrence of IE, except in chronic hemodialysis patients. [ABSTRACT FROM AUTHOR]

Background and Aim of the Study: The impact of adding papillary muscle approximation (PMA) to restrictive mitral annuloplasty (RMA) on postoperative left ventricular (LV) function is unknown. Changes in LV function parameters and clinical outcome were evaluated following RMA with and without PMA in patients with clinically relevant functional mitral regurgitation (FMR)., Methods: A total of 176 patients with advanced cardiomyopathy underwent RMA either with (n = 59) or without (n = 117) PMA. Propensity score analysis was used to adjust for group differences in several baseline characteristics, such as age, gender and LV ejection fraction (LVEF) (C-statistic = 0.80, goodness-of-fit value = 0.58)., Results: Serial echocardiography in 30 propensity score-matched pairs demonstrated decreases in LV end-systolic dimension (RMA alone: 57 ± 9 mm at baseline versus 54 ±11 mm at one month versus 56 ± 13 mm at latest examination; RMA + PMA: 56 ± 8 mm versus 53 ± 9 mm versus 48 ± 11 mm, respectively) and improvement in LVEF (RMA alone: 28 ± 8% versus 28 ± 11% versus 29 ± 10%; RMA + PMA: 30 ± 8% versus 30 ± 9% versus 36 ± 13%, respectively) in both groups. Greater degrees of changes in value were noted for patients receiving RMA + PMA (group effect p <0.05 for both). The two-year survival of both groups was similar (73 ± 8% versus 77 ± 23%, p = 0.7), but the RMA + PMA group showed a trend towards a greater freedom from composite events, defined as mortality and/or unscheduled heart failure re-admission (48 ± 9% versus 63 ± 9%, p = 0.1)., Conclusions: RMA + PMA induced greater long-term effects on unloading of the left ventricle and improvements in LV systolic function than did RMA alone. PMA may be a useful adjunct repair in combination with RMA, although its clinical benefits remain to be determined.