Evaluating Treatment Options for Patients With Infective Endocarditis

When Is It the Right Time for Surgery?

Aneil Malhotra; Bernard D Prendergast


Future Cardiol. 2012;8(6):847-861. 

In This Article

Conclusion & Future Perspective

Referral for surgery in IE involves a complex decision analysis that balances the risks of medical treatment with those of surgical intervention, including operative mortality and morbidity, the risks of long-term cardiac dysfunction and recurrent embolism, comorbidities and the complications of prosthetic valves and anticoagulation. The established role of surgery seems set to increase as the complexity of patients with IE rises and the benefits of early surgery become clearer. The future will hopefully see a more robust evidence base to guide management strategy. Nevertheless, decision-making in individual patients will remain challenging: expert input and multidisciplinary collaboration between cardiology, microbiology and cardiac surgery teams will always be required to achieve optimum outcome.