When Is Surgery Necessary for Native Valve Endocarditis?
When Is Surgery Necessary for Native Valve Endocarditis?
Critical Decisions
While antibiotics are the mainstay of treatment for native valve endocarditis, some patients require surgical intervention. Knowing when to consider surgery can be lifesaving.
Contents
- Indications for Surgery
- Timing of Surgery
- Surgical Procedures
Indications for Surgery
Surgery may be needed in cases of heart failure due to valve destruction, persistent infection despite antibiotics, or large vegetations with high risk of embolism. Other indications include heart block, valve ring abscesses, or certain fungal infections.
Timing of Surgery
The timing of surgery is crucial. Emergency surgery may be needed for severe heart failure or uncontrolled infection. In other cases, early surgery (within 1-2 weeks) may be beneficial. Some patients can complete antibiotic therapy before undergoing elective valve surgery.
Surgical Procedures
The most common surgery for native valve endocarditis is valve replacement with a mechanical or biological prosthesis. In some cases, valve repair may be possible. The choice depends on factors like patient age, valve involved, and extent of infection.
FAQs
How often is surgery needed for endocarditis?
About 40-50% of patients with native valve endocarditis require surgery.
Does surgery cure the infection?
Surgery removes infected tissue, but antibiotics are still needed to clear the infection.
What's the risk of surgery?
Surgical mortality is 10-20%, but risks of not operating may be higher.
Wrapping Up
While challenging, timely surgical intervention can be lifesaving in complicated cases of native valve endocarditis.
Additional References
- Baddour LM, et al. Circulation. 2015;132(15):1435-1486.
- Prendergast BD, Tornos P. Lancet. 2010;375(9713):387-398.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.