University Hospital of Nancy, 54511, Nancy, France,
Curr Infect Dis Rep. 2010 Jul;12(4):237-43. doi: 10.1007/s11908-010-0112-5.
Multivalvular endocarditis accounts for 15% of all endocarditis. The mechanisms of spread of the infection differs whether endocarditis is only left-sided (involving both the mitral and aortic valves) or bilateral. In left-sided bivalvular endocarditis, it is often a secondary mitral lesion following a primary aortic endocarditis. Multivalvular endocarditis often results in severe and extensive cardiac lesions, well described at echocardiography and frequently responsible for severe heart failure. Patients often need surgery, which consists of radical debridement of all the infected tissue with reconstruction using different types of prostheses; therefore, the surgery may be very complex. The goal should be an early diagnosis of endocarditis to avoid spread of the infection to more than one valve, to improve the prognosis for those patients.
多瓣膜心内膜炎占所有心内膜炎的 15%。感染的传播机制因心内膜炎仅为左侧（涉及二尖瓣和主动脉瓣）或双侧而异。在左侧双瓣心内膜炎中，通常是原发性主动脉心内膜炎后继发的二尖瓣病变。多瓣膜心内膜炎常导致严重广泛的心脏病变，在超声心动图上有很好的描述，常导致严重心力衰竭。患者通常需要手术，手术包括用不同类型的假体彻底清创所有感染组织并进行重建；因此，手术可能非常复杂。目标应该是早期诊断心内膜炎，以避免感染扩散到一个以上的瓣膜，从而改善这些患者的预后。
