Reviewing surgical video from a case study, we explore the complexity of diagnosing mitral valve endocarditis, especially when there is a risk of embolism. In this discussion we review:

• The key role that echocardiography plays in accurate diagnosis and management of native mitral valve endocarditis
• The importance of thorough CT exams to evaluate the possibility of systemic and cerebral septic embolic events 
• Optimal timing and technique for surgical intervention when there is a risk of cerebral embolic events

Aarti Patil, MD
Assistant Professor, Department of Cardiovascular Surgery
,Icahn School of Medicine at Mount Sinai 

Randolph P. Martin, MD
Clinical Professor, Department of Cardiovascular Surgery
Icahn School of Medicine at Mount Sinai