Endovascular treatment for intracranial mycotic aneurysms prior to cardiac surgery

Area of Science:

• Cardiology
• Neurology
• Infectious Diseases

Background:

• Infective endocarditis (IE) poses significant risks, including the development of intracranial mycotic aneurysms.
• The optimal management strategy for IE complicated by these aneurysms remains debated.
• Mitral regurgitation is a common cardiac complication associated with IE.

Observation:

• A 21-year-old male presented with mitral regurgitation and vegetations indicative of IE.
• The patient had a ruptured right anterior cerebral artery aneurysm and an unruptured left middle cerebral artery aneurysm.
• These intracranial aneurysms were directly linked to the infective endocarditis.

Findings:

• Successful endovascular embolization was performed for both the ruptured and unruptured cerebral aneurysms.
• Subsequent mitral valve repair was successfully completed.
• The combined therapeutic approach resulted in a favorable clinical outcome for the patient.

Implications:

• This case highlights the feasibility and success of a combined endovascular and surgical approach for IE with complex intracranial aneurysms.
• Early and aggressive intervention may be crucial for managing life-threatening complications of IE.
• This strategy offers a potential pathway for managing similar complex cases in the future.