Related Experiment Video
Updated: Jan 11, 2026
14:14
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
14.6K
[Aortic Valve Replacement for Active Infective Endocarditis with Multiple Cerebral Infarctions and Subarachnoid
Tatsuya Ogawa1, Masakazu Maeda, Satoru Otani
1Department of Cardiovascular Surgery, Iwakuni Clinical Center, Iwakuni, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|November 18, 2025
Summary
Surgical aortic valve replacement successfully treated a patient with infected aortic valve endocarditis, intractable heart failure, and severe neurological complications. This intervention led to a favorable outcome, demonstrating the efficacy of timely surgical management.
Area of Science:
- Cardiology
- Neurosurgery
- Infectious Diseases
Background:
- Infective endocarditis of the aortic valve can lead to severe complications, including heart failure and embolic events.
- Intractable heart failure and neurological deficits pose significant challenges in managing aortic valve endocarditis.
Purpose of the Study:
- To report a case of successful surgical intervention for infective aortic valve endocarditis with complex neurological sequelae.
- To highlight the role of aortic valve replacement in managing patients with severe heart failure and cerebral complications.
Main Methods:
- A 46-year-old male patient with fever, left hemiplegia, and echocardiographic evidence of severe aortic regurgitation and vegetation underwent aortic valve replacement.
- Preoperative imaging included brain CT and MRI to assess cerebral infarction and subarachnoid hemorrhage.
Main Results:
- Successful aortic valve replacement was performed despite existing neurological deficits and progressive pulmonary congestion.
- Postoperative course was uneventful, with stable neurological status and resolution of heart failure symptoms.
- The patient was discharged on postoperative day 46 after continued perioperative antibiotic administration.
Conclusions:
- Surgical treatment, specifically aortic valve replacement, can be effective in managing infective aortic valve endocarditis complicated by intractable heart failure and neurological events.
- Early surgical intervention should be considered in selected patients to improve outcomes and prevent further deterioration.
Related Concept Videos
01:18Endocarditis III: Medical Management
200
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
200
01:25Endocarditis I: Introduction
371
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
371
01:25Aortic Regurgitation III: Medical Management
379
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
379
01:25Endocarditis II: Clinical Features of Infective Endocarditis
381
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
381
01:15Aortic Regurgitation I: Introduction
442
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
442
01:26Aneurysm III: Interprofessional Care
247
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
247