A 64-year-old male patient was admitted to hospital with recurrent fever for more than two months. Preoperative laboratory tests revealed perioperative coagulation disorders

manifested as severe hypofibrinogenemia and thrombocytopenia

and serial dynamic monitoring of coagulation parameters was carried out throughout hospitalization. Physical examination showed no precordial bulge

normal cardiac dullness border

regular heart rate of 78 beats per minute. A diastolic murmur was heard over the aortic valve auscultation area

without extra heart sounds or gallop rhythm

and peripheral vascular signs were negative. Combined with clinical manifestations and transthoracic echocardiography findings

the patient was diagnosed with infective endocarditis

congenital bicuspid aortic valve

severe aortic regurgitation complicated with mild-to-moderate aortic stenosis. During treatment

subcutaneous injection of recombinant human thrombopoietin (TPO) was administered to elevate platelet count

combined with transfusion of platelet and other blood components

as well as intravenous infusion of human fibrinogen to correct coagulation defects. After thorough preoperative evaluation

the patient underwent Bentall procedure consisting of aortic valve replacement

ascending aorta replacement and coronary artery reimplantation. The patient maintained stable vital signs postoperatively

with clean and dry dressing on thoracic surgical incision and no signs of active bleeding. He was discharged after clinical stabilization

with instructions to take oral warfarin for lifelong standardized anticoagulation and receive regular follow-up with coagulation function monitoring.