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Early Surgery versus Conventional Treatment for Infective Endocarditis:
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Early Surgery versus Conventional Treatment for Infective Endocarditis:
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Forums  »  Open clinical  »  Cardiology  »  Early Surgery versus Conventional Treatment for Infective Endocarditis:

Early Surgery versus Conventional Treatment for Infective Endocarditis:

posted at 28/6/2012 12:10 AM BST on bmj.com
Posts: 3045
First: 27/3/2012
Last: 20/5/2013
                                                                                                         Despite advances in medical and surgical treatment, infective endocarditis remains a serious disease that carries a considerable risk of death and morbidity. The role of surgery in the treatment of infective endocarditis has been expanding, and current guidelines advocate surgical management for complicated left-sided infective endocarditis. Early surgery is strongly indicated for patients with infective endocarditis and congestive heart failure, but the indications for surgical intervention to prevent systemic embolism remain to be defined.
What are the current guidelines with respect to performance of early surgery on the basis of vegetation in infective endocarditis?

Consensus guidelines for the performance of early surgery on the basis of vegetation are controversial, and the 2006 ACC–AHA guidelines recommend early surgery as a class IIa indication only in patients with recurrent emboli and persistent vegetation. The revised 2009 European Society of Cardiology guidelines recommend early surgery as a class IIb indication in patients with isolated, very large vegetations (>15 mm in diameter).

Teaching Topics | June 28, 2012, The NEJM


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