Introduction: External radiation therapy has been the fundamental pillar when treating breast cancer. Partial radiation therapy and intraoperative radiation treatment have created modifications that allow the irradiation of the breast to be performed at the surgical act delivering a single large fraction or a "boost" dose directly at the tumor bed. We will discuss patients treated with INTRABEAM (Carl Zeiss Surgical Oberkochen, Germany) at the "Mastology Unit at Leopoldo Aguerrevere Clinic". Materials and Methods: The selection of patients is crucial for the success of the treatment, same protocol of treatment has been applied to every patient at the surgical act. Since September 2013 until February 2015, we have treated a total of 148 patients with the INTRABEAM unit, we will discuss the 114 patients treated by the team at the "Mastology Unit at Leopoldo Aguerrevere Clinic" with ages between 31 and 87 years in which 46% were single treatments and 54% were treated as a "boost" for external radiation therapy. Results: The procedure has been well tolerated with only a 17% of transient fibrosis and a 12% of seromas. We have had none mayor complications like dehiscence of the wound or necrosis of the borders. Conclusion: With this preliminary presentation, we would like to demonstrate that the technique and protocol used at our mastology unit with the intraoperative radiation treatment is safe and has many advantages to the patients including better comfort, cost-effective and with results comparable to external radiotherapy.

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The conglomerate of microorganisms, inflammatory cells, fibrin and platelets that constitutes the characteristic lesion of infectious endocarditis, that is, vegetation, was considered as a major criterion of infectious endocarditis in the 90s thanks to the development of ultrasound. Ecocardiography allows the diagnosis of complications derived from the infection, such as valvular perforation, prosthetic dehiscence, fistula or abscesses. One of the most infrequent complications is the mitral pseudoaneurysm. It has its origin in the impact of a jet of aortic regurgitation on the anterior leaflet of the mitral valve, which is why we have called it mitral fracking. A 60-year-old man who had a recent history of pneumonia and for whom he was still receiving antibiotic treatment, debuted suddenly with dyspnea of minimal effort. He went to a cardiology clinic where he was found to have severe mitral regurgitation. He was directly derived to cardiac surgery of our hospital. Prior to the intervention, a transesophageal ultrasound study was performed in our department, which showed the following findings: a bicuspid aortic valve with a small vegetation on its aortic surface (Figure A, surgical piece), a protuberance on the anterior mitral leaflet (Figure B) with internal flow that caused systolic expansion towards the atrium (Figure C) and diastolic collapse towards the ventricle (figure D): the mitral pseudoaneurysm. The therapeutic action was based on the replacement of both valves with mechanical prostheses. The blood cultures were negative, but the surgical piece revealed unequivocal histological findings of infectious endocarditis. Currently, the patient is stable and the valves are normofunctional in the regular follow-up controls. Abstract 91 Figure.