[A case of aortic valve replacement for active infectious endocarditis with multi-organ failure preoperatively]

A 57-year-old man underwent aortic valve replacement for active infectious endocarditis with multi-organ failure. He had become unconscious suddenly and had undergone transient pacing and endoteacheal intubation in the first hospital. Then he had been transferred to the second hospital, where careful medical treatment had been done for cardiac and hepatorenal failure. When he was transferred to our hospital, he was in New York Heart Association functional class IV with catecholamine support and had acute renal failure required hemodialysis. Aortic valve replacement with bileaflet mechanical valve and direct closure of perivalvular ring abscess made the patient free from catecholamine support and hemodialysis, while he needed permanent pacemaker implantation. This case suggests that both careful medical treatment before surgery and timing of surgical intervention were important for active infectious endocarditis with multi-organ failure preoperatively.