title: Mitral valve repair in active infective endocarditis with cerebral infarction.
abstract: A 19-year-old woman, who had a recent extensive cerebral infarction caused by a septic embolization in the left-sided territory of the middle cerebral artery, successfully underwent mitral valve repair for severe mitral regurgitation caused by active infective endocarditis, 24 h after the onset of stroke. Anticoagulation during cardiopulmonary bypass was maintained with low-dose heparin and additional nafamostat mesilate. She had no further aggravation of the brain complication and recovered well with midterm mitral valve durability.
authors.affiliation: Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Okada
authors.forename: Tomonori
authors.initials: T
authors.lastname: Shirasaka
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kano
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okita
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage; D001550:Benzamidines; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D038524:Diffusion Magnetic Resonance Imaging; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006146:Guanidines / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000382:microbiology*; D020766:Intracranial Embolism / Q000175:diagnosis / Q000382:microbiology*; D008943:Mitral Valve / Q000382:microbiology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D010496:Pericardium / Q000637:transplantation; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D001550:Benzamidines; D006146:Guanidines; D006493:Heparin; C032855:nafamostat
keywords: Cardiopulmonary bypass; bacterial; endocarditis; heart valve prosthesis implantation; mitral valve; stroke