Mitral valve repair during acute phase infective endocarditis with extensive destruction of the anterior leaflet rough zone and cerebral infarction.

Some reports suggest that mitral valve repair has good outcomes and may, therefore, be the preferred surgical approach in patients with active infective endocarditis (Doukas et al. in Heart 92(3):361-363, 2006); Ruttmann et al. in J Thorac Cardiovasc Surg 130(3):765-771, 2005; Sternik et al. in J Heart Valve Dis 11(1):91-97, 2002). However, in cases of active infective endocarditis of the mitral valve, extensive destruction of valvular tissue may make reliable valve repair difficult. Moreover, the timing of valve repair for active infective endocarditis remains controversial, especially in patients having cerebral complications. We present a case of a 34-year-old woman who had active infective endocarditis of the mitral valve complicated by multiple acute cerebral infarctions from septic embolisation. We could successfully carry out mitral valve repair 36 h after the diagnosis of active infective endocarditis and cerebral infarction was made. Her postoperative course was uneventful, and the patient remained in good health without recurrence of infective endocarditis and neurological complications.