Surgical Management: Indications and Technical Issues

摘要: A 48-year-old man, diagnosed with infective endocarditis (IE), had been in hospital for five days. Blood cultures consistently positive Staphylococcus aureus. Intravenous antibiotic treatment administered since hospitalization and modified as per culture results. Transesophageal echocardiography (TEE) on the second day revealed vegetations ventricular aspect of coronary aortic cusps, largest measuring 8 mm length moderate regurgitation, a large perforation anterior mitral leaflet moderately severe suspicious presence small abscess aortomitral curtain form very area minimal echolucency. Cardiac surgery was consulted, decision made to continue medical therapy repeat TEE two On 7 after admission, confirmed an previously suspected location curtain, significantly increased size compared previous images. Cultures were negative, but leukocytosis fever persisted. The patient taken operative room following urgent surgery. operation involved removal infected insufficient valve together root containing abscess. An homograft used replace removed valve, accompanying construct new curtain. edges native first debrided vegetations, autologous pericardial patch repair defect. Surgery then concluded sent stable condition intensive care unit postoperative completion course. This case illustrates importance early involvement cardiac IE significance treating present, or preventing imminent, hemodynamic instability, even face active infection. It also underscores role valuable means diagnosis follow-up.