# Severe Mitral Valve Regurgitation in Infective Endocarditis: A Case Report

## TL;DR

A patient with infective endocarditis and severe mitral valve damage underwent urgent valve repair but experienced post-surgical lung injury.

## Contribution

This case report highlights a rare presentation of infective endocarditis with mitral valve perforation and its surgical management.

## Key findings

- The patient had vegetations on both mitral and aortic valves with mitral valve perforation and severe regurgitation.
- Urgent mitral valvuloplasty and bioprosthetic aortic valve insertion were performed.
- Post-surgical lung injury occurred despite clinical improvement.

## Abstract

We present a case report of a patient with infective endocarditis. He came to the emergency room with respiratory failure due to severe pneumonia and pulmonary edema. On 2D transesophageal echocardiography, vegetations were seen in both mitral and aortic valves, with mitral valve perforation and severe regurgitation. His clinical presentation and severity of the disease made him suitable for urgent valve repair. He was submitted to mitral valvuloplasty with closure of the valve perforation and insertion of a bioprosthetic aortic valve. Despite significant clinical improvement, a post-surgical complication was noted with new-onset lung injury after cardiopulmonary bypass. This is an interesting case of a patient with suspected retrograde valve involvement, affecting the aortic valve, the mitral-aortic intervalvular fibrosa, and the mitral valve, ending with mitral valve abscess with leaflet perforation and valvular regurgitation.