Surgery for Infective Endocarditis

ABSTRACT

The last decade has seen many changes in the landscape of infective endocarditis (IE) - ranging from the epidemiology; microbiology; diagnostic techniques and indication for antibiotic prophylaxis. Unfortunately; the role of surgery in the patient with endocarditis; including the indication; timing and type of surgery continues to be plagued by controversy. Although surgery has an important and established role in critically ill patients with endocarditis; the choice between medical therapy and surgery is often less clear cut and poses a major challenge to the physician treating this condition. The following article summarises some of these controversies including indications for surgery in native and prosthetic valve endocarditis; the timing of surgery; the choice of prostheses and issues surrounding anti-coagulation