[Aortic Valve Replacement for Active Infective Endocarditis with Multiple Cerebral Infarctions and Subarachnoid Hemorrhage:Report of a Case].

We report a case of successful surgical treatment of infected aortic valve endocarditis with intractable heart failure, multiple cerebral infarction, and subarachnoid hemorrhage. A 46-year-old man who had fever for two weeks and subsequent left hemiplegia was admitted to our hospital. Brain computed tomography (CT) and magnetic resonance imaging (MRI) revealed multiple cerebral infarction and subarachnoid hemorrhage. Echocardiography showed severe aortic regurgitation with a huge mobile vegetation. Despite medical treatment, chest X-ray revealed progressive pulmonary congestion. We performed aortic valve replacement three days after admission. Cerebral hematoma got slightly larger, but neurological symptom did not worsen. Postoperative course was uneventful. Perioperative antibiotic administration was continued and he was discharged on the postoperative day 46.