Infective endocarditis and neurologic events: indications and timing for surgical interventions

N. Bonaros*, M. Czerny, B. Pfausler, S. Muller, T. Bartel, M. Thielmann, S.E. Shehada, T. Folliguet, J.F. Obadia, J. Holfeld, R. Lorusso, A. Parolari, L. Muller, M. Grimm, E. Ruttmann-Ulmer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

A therapeutic dilemma arises when infective endocarditis (IE) is complicated by a neurologic event. Postponement of surgery up to 4 weeks is recommended by the guidelines, however, this negatively impacts outcomes in many patients with an urgent indication for surgery due to uncontrolled infection, disease progression, or haemodynamic deterioration. The current literature is ambiguous regarding the safety of cardiopulmonary bypass in patients with recent neurologic injury. Nevertheless, most publications demonstrate a lower risk for secondary haemorrhagic conversion of uncomplicated ischaemic lesions than the risk for recurrent embolism under antibiotic treatment. Here, we discuss the current literature regarding neurologic stroke complicating IE with an indication for surgery.
Original languageEnglish
Pages (from-to)M19-M25
Number of pages8
JournalEuropean Heart Journal Supplements
Volume22
Issue numberM
DOIs
Publication statusPublished - 1 Nov 2020

Keywords

  • infective endocarditis
  • stroke
  • valve repair
  • Stroke
  • Infective endocarditis
  • Valve repair

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