ABSTRACT

Infective endocarditis (IE) usually affects the right-sided valves in hemodialysis (HD) patients. Hemodialysis catheter-related left-sided endocarditis is a very rare condition and has a high mortality. A 58-year-old male pa- tient who had been inserted a permanent HD catheter from the right subclavian vein 6 months ago was admitted with fever and dyspnea. Transesophageal echocardiography (TEE) revealed that the HD catheter extended to the left atrium by passing from interatrial septum (IAS). A vegetation in the interatrial septum, aortic valve, which formed a perforation in the mitral valve and leading to severe valve insufficiency was observed. The patient was planned to undergo an operation however he died as a result of impaired hemodynamic stability. Catheter site should be confirmed through an imaging method performed during or after the procedure in order to pre- vent catheter malposition. A proper antibiotic treatment should be started as soon as a catheter-related endocar- ditis is detected, a surgical decision should be done in the shortest and the most proper time.