Abstract: To evaluate the efficacy of mitral valvuloplasty for mitral valve insufficiency in infective endocarditis. Methods From March 2002 to January 2012, 33 patients with mitral valve insufficiency in infective endocarditis underwent mitral valvuloplasty at Beijing Fu Wai Cardiovascular Hospital, including 23 males and 10 females, aged 10-67 (35.7±17.8) years. 13 cases had underlying cardiac anatomic lesions. Preoperatively, there were 5 cases of mild mitral regurgitation, 15 cases of moderate regurgitation, and 13 cases of severe regurgitation. Five patients had NYHA class I, 23 had class II, 4 had class III, and 1 had class IV. All patients underwent mitral valvuloplasty, and 14 cases were operated in the active phase. At the same time, aortic valve replacement was performed in 6 cases, tricuspid valvuloplasty in 5 cases, coronary artery bypass grafting in 1 case, left atrial mucosal aneurysm resection in 1 case, and aortic sinus aneurysm repair in 1 case. The methods of formation included pericardial repair with perforation in 5 cases, leaflet resection with suture in 17 cases, double-port method of formation in 3 cases, tendon transfer and artificial tendon in 5 cases, and artificial formation ring in 15 cases. The result was one perioperative death, which was complicated by acute myocardial infarction at 7 d after surgery. 32 surviving patients all recovered and were discharged from the hospital. Echocardiography before discharge showed that the left ventricular end-diastolic internal diameter and left atrial internal diameter were (48.9±7.6) mm and (31.7±7.4) mm, respectively, with significant improvement compared with the preoperative period (P=0.000). 32 patients completed follow-up for 6 to 125 (73.0±38.6) months. One case underwent mitral valve mechanical valve replacement for mitral stenosis 3 years after surgery. There were 25 cases with NYHA class I, 5 cases with class II, and 2 cases with class III heart function. There were 4 cases of small amount of mitral regurgitation, 1 case of moderate regurgitation, and 26 cases of no regurgitation; 1 case of rapid diastolic mitral flow velocity (1.7 m/s) and 1 case of moderate aortic regurgitation. The differences in left ventricular end-diastolic internal diameter and left atrial internal diameter were not statistically significant compared with the early postoperative period, and the ejection fraction improved compared with the early postoperative period (60.9%±6.6% vs. 57.5%±6.7%; P=0.043). Conclusion Mitral valvuloplasty for mitral valve closure insufficiency in infective endocarditis is effective and reliable, with significant reduction in left atrial and left ventricular internal diameters and significant improvement in cardiac function.