Simultaneously performed mitral valve replacement and Hartmann's operation for infectious endocarditis from Streptococcus bovis and rectal cancer.

In patients with surgical indications for both cardiac surgery and a malignant neoplasm, cardiac surgery should generally be performed first; however, in some cases simultaneous surgery is recommended. We report a case of infectious endocarditis of the mitral valve caused by Streptococcus bovis with rectal cancer. Blood cultures showed a rise in coagulase-negative S. bovis, and the source of infection was thought to be the rectal cancer. The patient presented with cerebral infarction prior to surgery, and the possibility of recurrence of an infarction was predicted. The tumor of the rectum was hemorrhagic, so to avoid hemorrhagic complications due to perioperative heparinization and anticoagulant therapy and to remove the source of infection, mitral valve replacement and a Hartmann's operation were performed simultaneously. The postoperative course was uneventful.