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MRI Echo-Planar Imaging (EPI) sequence showing a right middle cerebral infarction.
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III para II female at 24 weeks of gestation was admitted to Maternal and Paediatric Critical Care Unit of Hassan II University Hospital for management of infectious endocarditis complicated with a right middle cerebral infarction (Figure 1). In the first examination, she had fever (38,5 C), left hemiplegia, a blood pressure of 160/70 mmHg, a pulse rate at 115 beats/min, and systolic and diastolic murmurs.
Large mobile vegetation attached to the ventricular side of the left cusp of aortic valve.
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The electrocardiogram showed sinus tachycardia without specific ST and T-wave changes; transthoracic echocardiography showed a left ventricular dilatation, an important aortic regurgitation with a large mobile vegetation attached to the ventricular side of the left cusp of aortic valve (Figure 2), and a moderate mitral regurgitation.
Removal of vegetation and aortic valve replacement using CPB:intraoperative image.
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Aortic replacement was done using cardiopulmonary bypass (CPB) (Figure 3) with a CPB time of 130 minutes and aortic cross-clamp time of 45 minutes.