Robotic Repair of Complex Mitral Valve Endocarditis with Pre-operative Embolic Neurologic Events

This is a young patient who presented with persistent fevers and was initially culture negative but a loud murmur on exam. TTE and TEE showed severe MR with mobile vegetations and suspected leaflet perforation. There was also a distinct sub-valvular vegetation that was very mobile. The patient also had presented with stroke symptoms and had recurring neurologic events despite appropriate antibiotics. A robotic repair of the native valve was performed with excision of vegetations and involved flail leaflet scallops, pericardial patch repair of a posterior leaflet perforation after debridement of surrounding vegetation and removal of the freely mobile vegetation from left ventricle. His fevers rapidly resolved postoperatively and he had no further neurologic events and no hemorrhagic extension of his previous, multiple bland embolic infarcts.