Timing chirurgico nell’endocardite infettiva valvolare

Translated title of the contribution: Surgical timing in infective valvular endocarditis

Michele Di Mauro*, Guglielmo Actis Dato, Sandro Sponga, Roberto Lorusso

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

The prevalence of valvular infective endocarditis (IE) is increasing and is burdened by high mortality and morbidity. Despite the higher risk, the surgical approach is superior to medical therapy alone, and over the years there has been a more aggressive attitude, with earlier indications for surgery. This article aims to review the available literature and the American and European guidelines in order to summarize the most appropriate surgical timing for valvular IE. Although there are discrepancies between the guidelines, an emergent indication (15-20 mm). Patients with signs of heart failure, persistence of positive cultures for more than 48-72 h despite antibiotic therapy, and in the presence of paravalvular lesions, advanced atrioventricular block and vegetations >10 mm should be operated early (within a few days). If any micro-organisms are isolated, including fungi or multi-resistant organisms in native IE or staphylococci or gram-negative pathogens in prosthesis IE, a more watchful approach (within 2 weeks) should be evaluated. In the presence of large cerebral embolic strokes or cerebral hemorrhage, re-evaluation at 2 and 4 weeks, respectively, is more appropriate. A multidisciplinary approach, especially in the most complex cases, seems to improve the outcome.

Translated title of the contributionSurgical timing in infective valvular endocarditis
Original languageItalian
Pages (from-to)890-895
Number of pages6
JournalGiornale Italiano di Cardiologia
Volume21
Issue number11
DOIs
Publication statusPublished - Nov 2020

Keywords

  • Heart valve dysfunction
  • Heart valve repair
  • Heart valve replacement
  • Heart valve surgery
  • Infective endocarditis
  • Timing of surgery
  • EARLY SURGERY
  • ANTIBIOTIC-THERAPY
  • CARDIAC-SURGERY
  • VALVE
  • MORTALITY
  • IMPACT
  • RISK
  • ASSOCIATION
  • GUIDELINES
  • MANAGEMENT
  • COMPLICATIONS

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