[Surgery for infective endocarditis].
Surgical treatment is a cornerstone in the management of infective endocarditis, approximately 50% of patients should be operated in the acute phase. Surgery is indicated in heart failure by acute valvular insufficiency refractory to medica treatment, persistent sepsis despite adequate antibiotic therapy, infections by microorganisms with low response to antibiotics, paravalvular abscess or cardiac fistulas, and for prevention of cerebral embolism when large vegetations are present. Other indication in prosthetic valve endocarditis is prosthesis dysfunction including significant perivalvular leaks or obstruction. In infection of leads of electrophysiological cardiac devices material should always be removed, preferably percutaneously, surgery is indicated when it is not technically possible.
Service de chirurgie cardiaque, institut de cardiologie, groupe hospitalier de La Pitié-Salpêtrière, 75651 Paris Cedex 13. alain.pavie@psl.aphp.fr
Alain
A
Pavie
Eleodoro
E
Barreda
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D000075202:Contraindications; D018450:Disease Progression; D024901:Drug Resistance, Multiple, Bacterial / Q000502:physiology; D004696:Endocarditis / Q000188:drug therapy / Q000601:surgery*; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000601:surgery*; D006333:Heart Failure / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D017211:Treatment Failure
D000900:Anti-Bacterial Agents