Multivalvular Endocarditis: A Different Approach.

Active infective endocarditis (IE) with multivalvular involvement, the most severe form of IE, requires a demanding clinical and surgical management. Clinical guidelines describe the operative approach to multivalvular involvement as challenging with subpar postoperative outcomes. Quadruple valvular IE remains a rare clinical phenomenon, with high mortality rates and poor surgical outcomes. We present the case of a 32-year-old woman with multivalvular IE who underwent a hemi-commando procedure and dual valve homograft replacement.