Double valve endocarditis

Background. There are little data concerning surgical outcomes in patients with native valve endocarditis affecting both the aortic and mitral valves. Methods. From 1977 to 1998, 54 patients had simultaneous aortic and mitral valve grafting for native valve endocarditis. In 78%, mitral valve involvem ent was limited to the anterior leaflet, suggesting a jet lesion from the a ortic valve. Surgical strategies included 31 valve repairs and valve replac ement with mechanical (34), bioprosthetic (34), or allograft (9) prostheses . Three hundred twenty-five patient-years of follow-up were available for a nalysis (mean 6.0 +/- 4.8 years). Results. There were no hospital deaths. Ten-year survival was 73%. Ten-year freedom from recurrent endocarditis was 84%, with risk peaking at 3 months , followed by a constant risk of 1.3%/yr. Choice of valvar procedure did no t influence mortality or reinfection risk. Conclusions. The most common pattern of double valve infection was a jet le sion on the anterior mitral leaflet. Surgical treatment has late survival a nd freedom from reinfection similar to those of patients with single heart valve infection.