Current best practices and guidelines indications for surgical intervention in infective endocarditis

Infect Dis Clin North Am. 2002 Jun;16(2):453-75, xi. doi: 10.1016/s0891-5520(01)00006-x.


Optimal diagnosis and management of patients with infective endocarditis requires sound clinical judgment based on extensive experience. This is especially important in regard to the indications and timing for surgery. To achieve the best possible outcomes, surgical intervention during treatment is required in 25% to 30% of patients with infective endocarditis. Heart failure and progressive left-sided valvular dysfunction are the most common indications for operation. Valve repair should be considered as an alternative to valve replacement whenever feasible, especially in younger patients. Successful management of perivalvular abscesses and prosthetic valve infections requires radical removal of infected tissue followed by reconstructive procedures performed by experienced surgeons. Emergency or urgent surgery should seldom be delayed.

Publication types

  • Guideline
  • Practice Guideline
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Drug Resistance, Bacterial
  • Embolism / microbiology
  • Embolism / surgery
  • Endocarditis / microbiology
  • Endocarditis / surgery*
  • Endocarditis, Bacterial / complications
  • Endocarditis, Bacterial / diagnosis
  • Endocarditis, Bacterial / surgery*
  • Heart Valve Diseases / complications
  • Heart Valve Diseases / diagnosis
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis / adverse effects
  • Humans
  • Mycoses / surgery
  • Risk Factors
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / microbiology
  • Time Factors