[Infectious endocarditis in cerebral death: implications for explantation of tissues and organs]

Allograft valve replacement is the preferred treatment for infectious endocarditis With severe annular destruction. Explantation of the valve in patients with cerebral death requires preliminary cardiac investigations and strict surgical procedures. The authors report two cases of right atrial endocarditis discovered at the time of explantation of the valvular allografts. In view of the infectious nature of the lesions, no tissues were resected. In both cases, transthoracic echocardiography had not diagnosed these lesions. The sensitivity of transoesophageal echocardiography in the diagnosis of these lesions should lead to systematic referral for this investigation. The infectious nature of these endocarditic lesions should raise suspicion about the presence of a central venous catheter. In addition, careful inspection of the chambers, septa and cardiac valves should be performed at surgery. The detection of potentially infectious endocarditic lesions should, in accordance with present recommendations, lead to renouncing the explantation of valvular allografts.