A surgical case of triple valve replacement for triple valve endocarditis with multiple vegetations

A 68-year-old man with cerebral infarction and right hemiplegia was diagnosed with active infective endocarditis, and multiple large vegetations and more than moderate valve regurgitation by three different valves were detected using transthoracic echocardiography. An urgent surgical intervention was selected, and aortic and mitral valve replacements using bioprostheses were initially performed due to large vegetation on both these valves with valve cusp destruction. Residual severe regurgitation persisted despite tricuspid valve plasty; therefore, tricuspid valve replacement using a tissue valve was performed, and triple valve replacement was eventually accomplished without any serious hemodynamic compromise. The postoperative clinical course was fair and the patient was discharged after 3 months of inpatient strict management and cardiac rehabilitation. However, he died approximately 9 months after the initial surgery due to multiple organ failure. We herein presented a rare surgical case of triple valve replacement for triple valve endocarditis with multiple large vegetations.