Two factors changed the clinical course of infective endocarditis dramatically: 1) The discovery and evolution of techniques for identifying and treating its microbiologic causes and 2) Valvular surgery. We retrospectively evaluated 43 (33.5%) patients (8 female, 35 male) from 4 to 65 years old of 128 patients with infective endocarditis who underwent surgical intervention. Indication for surgery were: Refractory congestive heart failure 14 (32.5%), prosthetic valves 10 (23.2%), large vegetation 6 (13.9%), recurrent endocarditis 4 (9.3%), ring abscess 4 (9.3%), brucella endocarditis 2 (4.6%), staph aureus endocarditis 3 (6.9%) and recurrent emboli 2 (4.6%). 30 to 50% of patients with infective endocarditis are operated during the active phase of the disease, this percentage is higher in case of aortic valve endocarditis, prosthetic valve endocarditis, some microorganisms such as staph aureus, gram negative bacilli, fungus and brucella. We suggest that internists refer patients for surgical intervention with infective endocarditis as early as possible in the active stage of infection.
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