Endocarditis mitroaórtica aguda en paciente con reparación mitral previa e infección intercurrente por COVID-19: controversia en la adherencia a las guías clínicas actuales

The new SARS-CoV-2 coronavirus is responsible for the current pandemic (COVID-19) and the consequent international health emergency. The clinical spectrum is broad, with recent reports of cases with cardiac involvement, mainly myocarditis, in COVID-19 patients. To date there are few reports of COVID-19 cases in need of heart surgery. The position of the Spanish Society of Cardiovascular and Endovascular Surgery (SECCE) has been to ensure the correct care of emerging and urgent patients, according to current clinical guidelines, however, in some cases the distinction between involvement of cardiac or pulmonary etiology can make the decision-making difficult. We present the case of a man with infective endocarditis and intercurrent infection with COVID-19, in which multidisciplinary consensus was essential to set the surgical indication, because his symptomatology generated controversy with current clinical guidelines of the European Society of Cardiology (ESC) on infective endocarditis. We consider that the adaptation of the guidelines during the current health emergency and the multidisciplinary decision-making can facilitate therapeutic action in complex cases of cardiac pathologies with surgical indication and COVID-19 coinfection.