Mutabi Erasmus, Boyarko Ben, Rowe Emerson, Ubaid Aamer, Popeck Michael, Uemura Tadahiro, Machado Lorenzo, Murickan Thomas, Tsukashita Masaki
Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
JACC Case Rep. 2025 Aug 6;30(22):104636. doi: 10.1016/j.jaccas.2025.104636.
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.
TAKE-HOME MESSAGE: 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.
并发感染性心内膜炎（IE）和终末期肝病由于临床风险重叠，带来了重大的围手术期挑战。
一名53岁男性，患有失代偿性肝硬化和IE，其特征为严重主动脉瓣反流以及赘生物延伸至主动脉二尖瓣间隔。他接受了复杂但成功的同期原位肝移植和心脏手术，包括双瓣膜置换以及使用补片修复重建主动脉二尖瓣间隔。
由于发病风险重叠，同期心脏和肝脏手术很少进行。本病例说明了多学科单阶段方法在特定高危患者中的可行性和潜在益处。
对于IE，同期原位肝移植手术和双瓣膜置换并进行主动脉二尖瓣间隔补片重建在非常特定的病例中可能可行，成功的结果取决于密切的多学科协作。
