RECONSTRUCTION OF THE MITRAL ANNULUS WITH PORCINE PERICARDIUM - REPORT OF A CASE WITH MITRAL ANNULAR DISRUPTION DUE TO STAPHYLOCOCCAL ENDOCARDITIS

A 60-year-old man was admitted to our hospital for investigation of dy spnea and disorientation with right hemiplegia. Echocardiography showe d thickened mitral valve leaflets with vegetations and severe mitral r egurgitation. Blood cultures grew Staphylococcus aureus. During the op eration, perforation and destruction of the mitral valve leaflets and vegetations were confirmed. Debridement of the infected tissues result ed in segmental disruption of the posterior mitral fibrous annulus. Re construction of the mitral annulus with porcine pericardium treated wi th glutaraldehyde and mitral valve replacement were successful. The pa tient's postoperative course was complicated with metastatic cerebral and splenic abscesses. After splenectomy on the 8th postoperative day, he gradually recovered without major neurologic sequelae. We believe that reconstruction of the mitral valve annulus with pericardium, espe cially autologous pericardium, is reliable and useful for the treatmen t of patients with disruption of the mitral valve annulus.