Endocarditis surgical indications


 * Associate Editors-in-Chief:

Overview
Indications for surgical debridement of vegetations and infected perivalvular tissue, with valve replacement or repair as needed are listed below:


 * 1) Moderate to severe congestive heart failure due to valve dysfunction
 * 2) Unstable valve prosthesis
 * 3) Uncontrolled infection for > 1–3 week despite maximal antimicrobial therapy
 * 4) Persistent bacteremia
 * 5) Fungal endocarditis
 * 6) Relapse after optimal therapy in a prosthetic valve
 * 7) Vegetation in Situ
 * 8) Prosthetic valve endocarditis with perivalvular invasion
 * 9) Endocarditis caused by Pseudomonas aeruginosa or other gram-negative bacilli that has not responded after 7–10 days of maximal antimicrobial therapy
 * 10) Perivalvular extension of infection and abscess formation
 * 11) Staphylococcal infection of prosthesis
 * 12) Persistent fever (culture negative)
 * 13) Large vegetation (>10 mm is associated with an increased risk of embolism)
 * 14) Relapse after optimal therapy in a native valve
 * 15) Vegetations that obstruct the valve orifice