A 67-year-old woman suffering from chronic atrial fibrillation and cadiomyopathy was transferred to our hospital for treatment of a left atrial thrombus. Echocardiography demonstrated the thrombus attached to the left atrial appendage, left ventricular dilatation and low ejectior fraction. Removal of the thrombus and radiofrequency Maze ablation were performed simultaneously under beating heart cardiopulmonary bypass. The patient showed no impairment of lefl ventricular function perioperatively and regained normal sinus rhythm.

A case of intracranial hemorrhage during valve surgery for infective endocarditis is reported. The patient was a 40-year-old man whose chief complaint was fever of unknown origin. Echocardiography demonstrated severe mitral regurgitation with vegetations. A blood culture demonstrated Streptococcus salivarius. He was treated with penicillin G and gentamicin for 6 weeks. Magnetic resonance imaging (MRI) was performed 10 days before surgery, but acute infarction, hemorrhage, or mycotic aneurysm were not observed. Mitral valve replacement was performed with a mechanical valve. Postoperatively, the patient had hemiplegia. Hemorrhage was visible in the right thalamus and left cerebellum on computed tomography. Ventricular drainage and removal of the cerebellar hematoma were performed the next day. These results suggest that to avoid cerebral complications during cardiac surgery for infective endocarditis, strict activated clotting time control and MRI just before surgery appear to be necessary.