Surgery for Right-Sided Infective Endocarditis: Surprise during Surgery

Infective Endocarditis is a dreadful disease. It most commonly involves the left side of the heart. Right-sided involvement is mainly seen in Intravenous drug users. The other causes are foreign bodies in the cavae or right atrium, congenital abnormalities, extensive burns, or severe infections of the skin. A thorough interrogation can help in considering IE as a provisional diagnosis. The most commonly isolated organism is Staphylococcus. The most important diagnostic tool is Echocardiography. Most of the cases do well with medical management, as tricuspid regurgitation is tolerated well. Surgery is required for right-sided disease in some rare situations. The patient described here had one such rare indication of large-sized, potentially embolic vegetations. Although the pathogenesis was not evident initially, proceeding to surgery revealed the cause.