Right-sided infective endocarditis (RSIE) localized to the right ventricular free wall is rare, and surgical excision of vegetations in such cases has seldom been reported. We describe a case of RSIE with the vegetations on the right ventricular free wall associated with ventricular septal defect (VSD) that was successfully treated with surgical intervention at an appropriate timing. The patient was a 30-year-old woman who had been diagnosed with a VSD shortly after birth. No surgical treatment had been performed and she had been followed conservatively. She was emergently transported to our hospital with disturbed consciousness caused by water intoxication due to psychogenic polydipsia. On admission, she presented with severe hyponatremia and elevated inflammatory markers. CT was performed, showing multiple bilateral pulmonary infiltrates, which were initially suspected to be pneumonia. After admission, blood cultures yielded Streptococcus mitis, and echocardiography showed two mobile vegetations on the right ventricular free wall, corresponding to a jet lesion caused by the VSD, leading to the diagnosis of RSIE. Subsequent contrast-enhanced CT showed filling defects in both pulmonary arteries, and septic pulmonary embolism (SPE) was diagnosed. Although antibiotic therapy improved inflammatory findings, the patient had a history of IE, which itself was an indication for VSD closure. In addition, we observed newly emerging, albeit minor, infiltrates in the lung fields. Therefore, we decided to proceed with elective surgery at that point. The vegetations on the right ventricular free wall was excised, the VSD was closed with an expanded polytetrafluoroethylene (ePTFE) patch, and the atrial septal defect incidentally found during surgery was also closed with direct sutures. Pathological examination of the excised specimen confirmed the infective vegetations. Including the period of postoperative oral antibiotic therapy, the total duration of antibiotic treatment was eight weeks. Her postoperative course was uneventful, and no recurrence was observed at 3 months after surgery.

Along with clinical practice and education, research is among the most important activities for medical doctors. The same is true in cardiovascular surgery: Young cardiovascular surgeons are expected to improve their surgical techniques and prioritize their clinical practice. However, their perspective on the role of research in their field of expertise is unknown. Therefore, we conducted a survey of and discussion with young cardiovascular surgeons to clarify their thoughts and concerns about performing research. Here we review and report the survey and discussion results.