Simultaneous Cardiac Surgery for Infective Endocarditis and Liver Transplantation in End-Stage Liver Disease

Area of Science:

• Cardiovascular Surgery
• Hepatobiliary Surgery
• Transplant Surgery

Background:

• Concurrent infective endocarditis (IE) and end-stage liver disease (ESLD) pose significant perioperative risks.
• Patients with ESLD often have comorbidities that complicate cardiac surgical procedures.

Observation:

• A 53-year-old male with decompensated cirrhosis and IE presented with severe aortic regurgitation and a vegetation extending into the aortomitral curtain.
• The patient underwent a simultaneous orthotopic liver transplantation and cardiac surgery.

Findings:

• The complex procedure involved double valve replacement and aortomitral curtain reconstruction with patch repair.
• The simultaneous surgery was successfully completed, demonstrating feasibility in a high-risk patient.

Implications:

• This case highlights the potential benefit of a single-stage, multidisciplinary approach for select patients with concurrent IE and ESLD.
• Successful outcomes depend on close collaboration between cardiac and transplant surgical teams.