Infective endocarditis and outcomes of mitral valve replacement.

Background: We investigated the long‐term outcomes of mitral valve replacement (MVR) in native mitral valve infective endocarditis (IE). Methods: Multicentre, population‐based cohort register study consisted of 1233 consecutive adult patients treated with first‐time MVR in Finland. Mitral valve IE was diagnosed in 170 of these patients. Propensity score matching resulted in 134 pairs with balanced baseline characteristics. The median follow‐up was 6.1 years. Results: Pre‐operative native mitral valve IE was associated with an increased hazard of 10‐year mortality (38.8% vs 30.5%; HR 2.13; CI 1.17‐3.85; P =.013) after MVR. Occurrence of major bleeding was higher in IE patients (26.0%) vs non‐IE patients (23.4%) during the 10‐year follow‐up (HR 2.80; CI 1.01‐7.77; P =.048). Hospital admission duration after MVR was longer in IE patients (median 28 vs 11 days; P <.0001). Cumulative ischaemic stroke rate was similar between patient groups (12.1% in IE vs 15.1% in non‐IE; P =.493). Re‐sternotomy was performed in 13.4% of IE patients and 9.0% of non‐IE patients (P =.261). Conclusions: Patients with native mitral valve IE have a higher risk of death and major bleeding after MVR than matched patients without IE. Results highlight the importance of complication prevention in these patients. [ABSTRACT FROM AUTHOR]