Analysis of surgical versus medical therapy in active complicated native valve infective endocarditis

Surgery for Infective Endocarditis

“…14,15 Studies from the 1970s and 1980s compared medical and surgical treatment of congestive heart failure complicating IE and demonstrated a consistent reduction in mortality after surgery, from a range of 56% to 86% to a range of 11% to 35%. 41,42 Although no correction was made for underlying comorbidity, similar results were reported in 2 more recent Scandinavian studies, 26,43 in which the best results were obtained with early intervention within 1 week of presentation. Early valve surgery in patients with congestive heart failure is associated with a substantial reduction in mortality compared with medical therapy alone, 5,15,21,22,44 and this scenario is now the most common and clearest indication for surgery, being present in 72% of patients who underwent early intervention in a recent European series.…”

Infective Endocarditis in Childhood: 2015 Update

“…138,139 The greatest risk for this complication exists in aortic valve endocarditis. Periannular infections also cause fistulous tracks into the pericardium, as well as between cardiac chambers or vascular structures.…”

Diagnosis and Management of Infective Endocarditis and Its Complications

“…96,99,100 Perivalvular cavities form when annular infections break through and spread into contiguous tissue. In native aortic-valve IE, this generally occurs through the weakest portion of the annulus, which is near the membranous septum and atrioventricular node.…”