Native valve infective endocarditis: what is the optimal timing for surgery?
IE remains a dreaded disease masquerading under a myriad of presentations in an evolving epidemiological environment. In our continuing endeavor against this deadly disease, echocardiography has evolved into an indispensable diagnostic tool to define structural complications and guide therapy. Timing of surgical intervention for IE remains a subject of intense debate and depends on the cardiac and systemic complications of the infection, the virulence of the organism, and the responsiveness to medical therapy. A judicious agreement among cardiologist, cardiovascular surgeon, and infectious disease specialist should define whether surgical intervention is warranted and, if so, the optimal timing. Further optimization of guidelines will help in the diagnosis and treatment of endocarditis but will never be a substitute for sound judgment and experience.
Chamoun
A J
AJ
Division of Cardiology, University of Texas Medical Branch, Galveston 77555-0553, USA.
Conti
V
V
Lenihan
D J
DJ
D000208:Acute Disease; D000328:Adult; D000792:Angiography; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality / Q000601:surgery*; D006351:Heart Valves / Q000382:microbiology* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality / Q000601:surgery; D013211:Staphylococcus aureus; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents