Simultaneous Cardiac Surgery for Infective Endocarditis and Liver Transplantation in End-Stage Liver Disease

Concurrent infective endocarditis (IE) and end-stage liver disease present significant perioperative challenges due to overlapping clinical risks. A 53-year-old man presented with decompensated cirrhosis and IE characterized by severe aortic regurgitation and vegetation extending into the aortomitral curtain. He underwent a complex, yet successful, simultaneous orthotopic liver transplantation and cardiac surgery, which included double valve replacement and reconstruction of the aortomitral curtain using a patch repair. Simultaneous cardiac and liver surgery is rarely performed because of overlapping risks of morbidity. This case illustrates the feasibility and potential benefit of a multidisciplinary, single-stage approach in select high-risk patients. Concurrent orthotopic liver transplant surgery and double valve replacement with aorticmitral curtain patch reconstruction for IE can be feasible in very select cases, with successful outcomes hinging on close multidisciplinary collaborations.