Dialysis Patient's Infective Endocarditis with Only 5% Survival Rate Saved by Two Open-Heart Surgeries
A 37-year-old dialysis patient in Hualien, Taiwan, suffering from severe infective endocarditis, was saved after undergoing two emergency open-heart surgeries, a procedure with only a 5% survival rate. The dedication of the medical team and the family's decision led to the patient overcoming the crisis and heading towards recovery.
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- 📰 Published: May 5, 2026 at 18:10
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HUALIEN, Taiwan (CNA) -- A 37-year-old female dialysis patient in Hualien, Taiwan, sought medical attention for unexplained high fever. Min-Sheng General Hospital diagnosed her with infective endocarditis, where her aortic valve was eroded by bacteria. After the initial surgery, a life-threatening hemorrhage occurred, necessitating an emergency second open-heart surgery. The surgery, which has only a 5% survival rate, was successful, saving the patient's life.
Early last year, the patient, surnamed Chen, began experiencing dizziness and headaches, which she mistook for a common cold. She intermittently took cold syrup for treatment. After six months, she developed lower limb edema, weakness, and repeatedly fell while walking. Upon seeking medical attention, she was diagnosed with worsening kidney function, requiring long-term dialysis.
Between dialysis sessions, Ms. Chen frequently suffered from persistent high fevers, with her condition fluctuating and sometimes reaching 39 degrees Celsius, which even antipyretics could not control. After being admitted to the emergency room, Dr. Chen Han-hsing, director of Min-Sheng General Hospital's Cardiovascular Center, used echocardiography to identify the critical lesion: a bacterial vegetation approximately 1.5 cm in size attached to Ms. Chen's aortic valve.
The medical team diagnosed infective endocarditis. Bacteria attached to heart valves not only destroy heart structures but can also detach and travel with the bloodstream, causing strokes or systemic embolisms. The hospital immediately transferred the patient to the intensive care unit and administered high-dose intravenous antibiotics. However, the infection was not controlled, her body temperature continued to soar, her consciousness gradually became confused, and sepsis rapidly worsened.
Dr. Huang Jen-ming, the chief surgeon and director of cardiac surgery, assessed that the first-line treatment for infective endocarditis is antibiotics, but approximately 40-50% of patients ultimately require surgical intervention. Ms. Chen's bacterial mass exceeded 1.5 cm, combined with severe aortic valve regurgitation, and uncontrolled infection, met the criteria for emergency surgery.
“Without surgery, death is almost 100% certain!” said Dr. Huang. Ms. Chen's long-term dialysis, sepsis, and poor health made her barely able to withstand such an operation; but this was not a choice, but a forced decision with no other options.
Dr. Huang stated that the moment the aorta was opened, the operating room fell silent. The scene before them was even more severe than what imaging tests had shown. The aortic valve was completely eroded by bacteria, with numerous vegetations attached; the aortic root had an erosion of about 1 cm, barely supported by the outer membrane; and the opening of the left coronary artery had a 0.7 cm tear.
Facing the sudden and complex lesions, Dr. Huang contacted Dr. Chiu Kuan-ming, superintendent of Far Eastern Memorial Hospital, by phone to discuss whether to perform a extensive aortic root replacement (Bentall procedure) or adopt a repair strategy. Considering the patient's overall condition, which could not withstand a long, high-intensity surgery, repair was suggested as the priority to ensure a safe exit from the operating table.
Dr. Huang immediately adjusted the surgical strategy according to the suggestion, performing precise repairs on the extremely fragile tissue to give the patient a critical chance at survival. The chief surgeon used very fine sutures to meticulously repair the ruptured vessel wall through relatively healthy tissue, and then completed the artificial valve replacement.
Four hours after the surgery, the patient temporarily stabilized. However, fate was unkind. That afternoon, Ms. Chen suffered a sudden massive hemorrhage. Over 1000 ml of fresh blood flowed from the drainage tube in a short period, and her blood pressure plummeted.
The intensive care unit issued an emergency alert, and the team immediately determined that the aortic suture site had likely ruptured. Her father was called into the operating room for the second time. There was no time to think, no other options. The doctors informed him that the risks were extremely high, and it might even be impossible to stop the bleeding.
Facing a surgery with only a 5% survival rate, Ms. Chen's father decided to take another gamble. He said, “Actually, I was mentally prepared. The doctors said the situation was very serious, and I knew this was no ordinary illness. If the doctors asked me to sign, I would sign. I just trusted them. At this point, there’s no other choice but to try!”
After two open-heart surgeries, the patient's condition gradually stabilized. Her high fever subsided, sepsis was controlled, she was successfully weaned off the ventilator, and transferred out of the intensive care unit. A follow-up echocardiogram on April 9 showed that the artificial valve was functioning normally, with no residual infection. The Min-Sheng General Hospital medical team once again saved a precious life. (Edited by Hsieh Ya-chu) 1150505
Early last year, the patient, surnamed Chen, began experiencing dizziness and headaches, which she mistook for a common cold. She intermittently took cold syrup for treatment. After six months, she developed lower limb edema, weakness, and repeatedly fell while walking. Upon seeking medical attention, she was diagnosed with worsening kidney function, requiring long-term dialysis.
Between dialysis sessions, Ms. Chen frequently suffered from persistent high fevers, with her condition fluctuating and sometimes reaching 39 degrees Celsius, which even antipyretics could not control. After being admitted to the emergency room, Dr. Chen Han-hsing, director of Min-Sheng General Hospital's Cardiovascular Center, used echocardiography to identify the critical lesion: a bacterial vegetation approximately 1.5 cm in size attached to Ms. Chen's aortic valve.
The medical team diagnosed infective endocarditis. Bacteria attached to heart valves not only destroy heart structures but can also detach and travel with the bloodstream, causing strokes or systemic embolisms. The hospital immediately transferred the patient to the intensive care unit and administered high-dose intravenous antibiotics. However, the infection was not controlled, her body temperature continued to soar, her consciousness gradually became confused, and sepsis rapidly worsened.
Dr. Huang Jen-ming, the chief surgeon and director of cardiac surgery, assessed that the first-line treatment for infective endocarditis is antibiotics, but approximately 40-50% of patients ultimately require surgical intervention. Ms. Chen's bacterial mass exceeded 1.5 cm, combined with severe aortic valve regurgitation, and uncontrolled infection, met the criteria for emergency surgery.
“Without surgery, death is almost 100% certain!” said Dr. Huang. Ms. Chen's long-term dialysis, sepsis, and poor health made her barely able to withstand such an operation; but this was not a choice, but a forced decision with no other options.
Dr. Huang stated that the moment the aorta was opened, the operating room fell silent. The scene before them was even more severe than what imaging tests had shown. The aortic valve was completely eroded by bacteria, with numerous vegetations attached; the aortic root had an erosion of about 1 cm, barely supported by the outer membrane; and the opening of the left coronary artery had a 0.7 cm tear.
Facing the sudden and complex lesions, Dr. Huang contacted Dr. Chiu Kuan-ming, superintendent of Far Eastern Memorial Hospital, by phone to discuss whether to perform a extensive aortic root replacement (Bentall procedure) or adopt a repair strategy. Considering the patient's overall condition, which could not withstand a long, high-intensity surgery, repair was suggested as the priority to ensure a safe exit from the operating table.
Dr. Huang immediately adjusted the surgical strategy according to the suggestion, performing precise repairs on the extremely fragile tissue to give the patient a critical chance at survival. The chief surgeon used very fine sutures to meticulously repair the ruptured vessel wall through relatively healthy tissue, and then completed the artificial valve replacement.
Four hours after the surgery, the patient temporarily stabilized. However, fate was unkind. That afternoon, Ms. Chen suffered a sudden massive hemorrhage. Over 1000 ml of fresh blood flowed from the drainage tube in a short period, and her blood pressure plummeted.
The intensive care unit issued an emergency alert, and the team immediately determined that the aortic suture site had likely ruptured. Her father was called into the operating room for the second time. There was no time to think, no other options. The doctors informed him that the risks were extremely high, and it might even be impossible to stop the bleeding.
Facing a surgery with only a 5% survival rate, Ms. Chen's father decided to take another gamble. He said, “Actually, I was mentally prepared. The doctors said the situation was very serious, and I knew this was no ordinary illness. If the doctors asked me to sign, I would sign. I just trusted them. At this point, there’s no other choice but to try!”
After two open-heart surgeries, the patient's condition gradually stabilized. Her high fever subsided, sepsis was controlled, she was successfully weaned off the ventilator, and transferred out of the intensive care unit. A follow-up echocardiogram on April 9 showed that the artificial valve was functioning normally, with no residual infection. The Min-Sheng General Hospital medical team once again saved a precious life. (Edited by Hsieh Ya-chu) 1150505