[Clinical Considerations in the Surgical Management of Active Infective Endocarditis of the Mitral Valve].

In the surgical management of infective endocarditis (IE), the presence of circulatory failure from valve destruction and vegetation embolization are important factors in determining the timing of surgery. Emergency surgery carries certain risks, such as infection control problems due to the unknown portal of entry of bacteria and infection, and the possibility of worsening cerebral hemorrhage in patients with hemorrhagic cerebrovascular disease. In recent years, there has been a trend toward more aggressive attempts at mitral valve repair for mitral IE, with improved success rates and rates of recurrent mitral regurgitation, and some reports suggesting that valve repair for active IE has better longterm survival rates than valve replacement. One possible factor is that early surgical intervention to resect the lesion may have a significant impact on the cure rate by preventing progression of valve destruction and controlling infection. Based on our clinical experience, we discuss the optimal timing of surgical intervention for mitral valve IE and present the postoperative remote survival rate, avoidance rate of reinfection, and avoidance rate of reoperation.