[On-pump beating aortic valve replacement for severe aortic regurgitation due to infective endocarditis].

A 37-year-old man was suffering from pneumonia and severe aortic regurgitation due to acute aortic valve endocarditis with the annular abscess with Staphylococcus aureus. Preoperative serum brain natriuretic peptide was over 2,000 pg/ml. Preoperative arterial oxygen saturation was 82% on mechanical ventilation (Fio2: 1.0) with nitric oxide inhalation. Under a full median sternotomy, total normothermic cardiopulmonary bypass was established. Using the normothermic retrograde continuous coronary sinus perfusion of oxygenated blood, on-pump beating aortic valve replacement (AVR) was performed. Veno arterial bypass was required for 72 hours postoperatively. Postoperative course was otherwise uneventful. On-pump beating AVR seemed to be one of the useful procedures for a high-risk patient.