Huge mycotic aneurysm of the superior mesenteric artery complicated with multiple subarachnoid hemorrhage

The optimal timing for open surgical repair in the case complicated with mycotic aneurysm and intracranial bleeding remains controversial. Here we report a case of infective endocarditis complicated with a huge mycotic aneurysm of superior mesenteric artery and multiple subarachnoid hemorrhage. Because the aneurysm of superior mesenteric artery has good collateral circulation, simple ligation was chosen. Then, he underwent minimally invasive cardiac surgery successfully under strict control of blood pressure and activated clotting time. Despite complication with intracranial bleeding, invasive open surgery is sometimes mandatory. It is essential to evaluate complications related to infectious endocarditis using multimodality imaging.