MINI-SYMPOSIUM

Indications and optimal timing for surgery in infective endocarditis

F Delahaye, M Célard, O Roth, G de Gevigney

Hôpital cardiovasculaire et pneumologique, Lyon, France

Correspondence to:
Correspondence to:
Professor François Delahaye
Hôpital cardiovasculaire et pneumologique, BP Lyon Montchat, 69394—Lyon Cedex 03, France; francois.delahaye @ chu-lyon.fr

Keywords: infective endocarditis; surgery

The first 150 words of the full text of this article appear below.

More and more patients are operated on during the active phase of infective endocarditis (IE).¹ Between 1991 and 1999, in France, the rate of cardiac surgery has increased from 31% to 50%.¹ This may, at least in part, explain the concomitant decrease of in hospital mortality, from 22% to 17%.¹ Nonetheless, the indications for cardiac surgery and its optimal timing remain difficult decisions.

The principal indications for cardiac surgery are heart failure, no control of infection, embolisms, large size of vegetations, severe valvar and perivalvar lesions, and infection caused by some microorganisms.

If heart failure is present, the mortality rate of native valve infective endocarditis is 55–85% in the case of medical treatment only and 10–35% in operated patients.²

The first indication for cardiac surgery in infective endocarditis is heart failure: it represents more than half of the indications. Heart failure caused by aortic regurgitation is particularly poorly tolerated (heart . . . [Full text of this article]

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