Key result
Mitral valve repair using low-dose heparin and nafamostat mesilate during cardiopulmonary bypass was successfully performed 24 hours after stroke onset without aggravating brain complications.
Case Report (n=1)
Early mitral valve repair using low-dose heparin and nafamostat mesilate for cardiopulmonary bypass can be safely performed 24 hours after extensive cerebral infarction in a patient with active infective endocarditis.
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Supports feasibility of early mitral valve repair after stroke in endocarditis; hypothesis-generating and should not change practice without prospective data.
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.
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Okada et al. (2013) conducted a case report in Active infective endocarditis with cerebral infarction and severe mitral regurgitation (n=1). Mitral valve repair with low-dose heparin and nafamostat mesilate during cardiopulmonary bypass was evaluated on Clinical recovery and mitral valve durability. Mitral valve repair using low-dose heparin and nafamostat mesilate during cardiopulmonary bypass was successfully performed 24 hours after stroke onset without aggravating brain complications.
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