Surgery for prosthetic valve endocarditis
- Adolf W Karchmer, MD
Adolf W Karchmer, MD
- Professor of Medicine
- Harvard Medical School
- Rakesh M Suri, MD, DPhil
Rakesh M Suri, MD, DPhil
- Professor of Surgery
- Cleveland Clinic
- Section Editors
- Scott E Kasner, MD
Scott E Kasner, MD
- Section Editor — Stroke
- Professor of Neurology
- University of Pennsylvania School of Medicine
- Catherine M Otto, MD
Catherine M Otto, MD
- Editor-in-Chief — Cardiovascular Medicine
- Section Editor — Cardiac Evaluation; Valvular Disease
- Professor of Medicine
- University of Washington
Infection of a prosthetic heart valve can be difficult to diagnose and manage. Optimal treatment of prosthetic valve endocarditis (PVE) requires:
●Identification of the causative microorganism.
●Selection of a bactericidal antimicrobial regimen of proven efficacy.
●A clear understanding of the intracardiac pathology and attendant complications of PVE (see "Epidemiology, clinical manifestations, and diagnosis of prosthetic valve endocarditis").
●Surgical intervention (in selected cases), especially when infection has extended beyond the valve to contiguous cardiac tissue or resulted in major valvular dysfunction.
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- Hussain ST, Shrestha NK, Gordon SM, et al. Residual patient, anatomic, and surgical obstacles in treating active left-sided infective endocarditis. J Thorac Cardiovasc Surg 2014; 148:981.
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- GENERAL CONCEPTS
- INDICATIONS FOR SURGERY
- Heart failure
- Paravalvular invasion
- Microorganisms usually requiring surgery
- Relapse after optimal medical therapy
- ANTIBIOTIC THERAPY FOLLOWING SURGERY
- COMPLICATIONS AND OUTCOMES
- TRANSCATHETER HEART VALVES
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS