Endovascular Treatment for an Infectious Aneurysm Prior to Cardiac Surgery: A Case Report

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Objective: In patients with infectious endocarditis requiring cardiac surgery, the presence of unruptured infectious intracranial aneurysms is an important issue. We report a patient in whom endovascular treatment for an unruptured infectious intracranial aneurysm was performed prior to cardiac surgery.

Case Presentation: A 20-year-old woman was admitted with infectious endocarditis. During the assessment, a cerebellar abscess was noted and drainage was conducted. An infectious intracranial aneurysm was observed in the posterior cerebral artery and treatment with an antimicrobial drug was continued. Due to severe heart failure, cardiac surgery was required, but there was a slight increase in the aneurysmal size. Intra-aneurysmal embolization was performed while preserving the parent artery. Subsequently, valve plasty was conducted. The patient was discharged.

Conclusion: If cardiac surgery is necessary, the treatment of infectious intracranial aneurysms should be performed in advance. If the heart failure is severe, endovascular treatment, which does not influence hemodynamics, may be useful.