Infective endocarditis and neurologic events: indications and timing for surgical interventions

Figures

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  Figure 1. Magnetic resonance imaging: intracranial abscess at the left parietal side. The female patient received a mitral valve repair and underwent successful neuro-surgical intervention at the fourth post-operative day. She regained full neurologic recovery without sequelae.

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  Figure 2. Contrast agent magnetic resonance angiography: 3 mm × 2.5 mm large mycotic aneurysm of a M2-branch of the middle cerebral artery at the right side. The male patient suffered from severe aortic valve endocarditis with paravalvular abscess formation (Staphylococcus aureus). Neurosurgical intervention was performed 3 days before aortic root replacement therapy. He died due to septic multi-organ failure but without intracerebral haemorrhage.

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  Figure 3. The upper panel shows paravalvular abscess, fistula to the right atrium complicating severe aortic valve endocarditis with vegetations are larger than 1 cm. Lower panel shows the aortic valve to be bicuspid with two- and three-dimensional display of a vegetation characterized by distinctive tissue Doppler motion pattern. A, abscess; F, fistula; LA, left atrium; LCA, left coronary artery; PML, pacemaker lead; RA, right atrium; V, vegetation.