Surgical Treatment of Infective Endocarditis

In-hospital mortality of patients with infective endocarditis remains unchanged at 20-30%. Cardiac surgery is required in addition to antibiotic therapy in approximately half of all endocarditis patients. The main indications for surgery are heart failure, locally or systemically uncontrolled infection, and prevention of embolic events. The timing of the surgical intervention is also of utmost importance. Despite the risks of surgery, it is often the only curative approach and provides a significant survival advantage in selected patients compared to antibiotic therapy alone. The following article discusses the principles of surgical therapy for infective endocarditis regarding indications, risks, and timing.