who should get surgical treatment for Endocarditis
- signs of heart failure
- severe valve dysfunction
- Invasion of paravalvular abscess or cardiac fistula
- recurrent systemic embolization
- large mobile vegetations.
- systemic sepsis despite 5-7 days of ab therapy
what % of patients that have endocarditis have complications that will require an operation?
Most common preventable complication of IE
- what does that mean for the threshold to operate?
The most common preventable complication is embolization
that means that there is a lower threshold to operate with mobile vegetation
Surgery for Q-fever endocarditis
generally indicated for hemodynamic reasons.
If possible, at least three weeks of antimicrobial treatment should be given prior to valve replacement.
Mortality Rate for infective endocarditis
in-hospital: 15% to 20%
What Organisms that are typical of Endocarditis should raise suspicion.
- Viridans streptococci
- Streptococcus bovis
- HACEK group (Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella spp, and Kingella kingae),
- S. aureus;
- community-acquired enterococci
in the absence of a primary focus
Frequency of endocarditis amoung patients with Staph Aureus Bacteremia
therefore TEE is reasonable