P194 DESTRUCTIVE AORTIC VALVE ENDOCARDITIS WITH INVOLVEMENT OF THE MITRO–AORTIC CURTAIN: A SUCCESSFUL “UFO” PROCEDURE

Abstract Infective endocarditis is a relatively rare disease with an estimated mean incidence of 3.6–7.0 cases per 100,000 subject–years. Aortic bicuspid disease, the most frequent congenital anomaly, one main risk factors. Heart failure, uncontrolled infection (fistulas, abscesses, persistently positive blood cultures) and systemic embolization are among feared complications endocarditis: these constitute indication for emergency/urgent cardiac surgery. An example extremely demolitive surgery Commando or "UFO" procedure, which consists in double replacement aortic valve mitral reconstruction mitro–aortic junction. The clinical case concerns 36–year–old man who went to emergency room high fever shivering. Having been found cultures MSSA having emerged vegetation by echocardiogram, diagnosis infective was made. During hospitalization, multi–organ cardioembolic phenomena (e.g. splenic, cerebral) hemorrhagic cerebral infarction occurred: therefore, accordance current guidelines, conservative treatment temporarily opted for. However, following days deterioration clinical–haemodynamic picture such as require patient thus subjected UFO procedure mitral–aortic Severe bi–ventricular dysfunction first time at post–operative echocardiographic control, need mechanical support circulation (AV ECMO, Impella). remainder hospitalization characterized progressive recovery ventricular function (LVEF 16% 44%), therefore discharged discrete hemodynamic compensation, despite multiorgan sequelae (hepatic, neurological, renal).