Methods: Ten patients were referred to our clinic with the diagnosis of Brucella endocarditis. The patients were given a medical treatment with triple antibiotherapy including doxycycline, rifampin and ceftriaxone. In the preoperative period, one of the patients had a sign of splenic infarction due to septic embolization. Echocardiographic evaluation revealed the development stages of the mitral valve injury due to Brucella endocarditis in another patient. All patients underwent open heart surgery immediately after reducing fever and relieving other symptoms.

Results: Six patients underwent aortic valve replacement (AVR), whereas three of them underwent both aortic and mitral valve replacement. In addition, AVR in combination with mitral ring annuloplasty were performed on one of the patients. Perforation of the aortic cusps was found in four patients. Perforation located in the commissure between the right and left coronary cusps was detected in one patient. Morbidity and mortality didn't developed in our patients. All patients were discharged with double antibiotherapy for a mean follow-up of four months (range, 2 to 6 months). None of the patients required re-hospitalization or re-surgery during the long-term follow-up period.

Conclusion: Our results show that surgical therapy must be combined with adequate preoperative antibiotherapy in cases with severe valve injury. Maintenance therapy with antibiotherapy should be optimized postoperatively on the basis of scheduled visits for successful definitive therapy and long-term quality of life.