Mitral and aortic valve endocarditis together with mitral cleft developing due to an incorrectly inserted permanent hemodialysis catheter

AbstractInfective endocarditis (IE) usually affects the right-sided valves in hemodialysis (HD) patients. Hemodialysis catheter-related left-sided endocarditis is a very rare condition and has a high mortality. A 58-year-old male patient who had been inserted a permanent HD catheter from the right subclavian vein 6months ago was admitted with fever and dyspnea. Transesophageal echocardiography (TEE) revealed that the HD catheter extended to the left atrium by passing from interatrial septum (IAS). A vegetation in the interatrial septum, aortic valve, which formed a perforation in the mitral valve and leading to severe valve insufficiency was observed. The patient was planned to undergo an operation however he died as a result of impaired hemodynamic stability. Catheter site should be confirmed through an imaging method performed during or after the procedure in order to prevent catheter malposition. A proper antibiotic treatment should be started as soon as a catheter-related endocarditis is detected, a surgical decision should be done in the shortest and the most proper time