Băluță Mariana Monica, Vintilă M.M.
Carol Davila University Of Medicine, Cardiology Department “St Pantelimon” Hospital, Bucharest, Romania
Abstract
Infective endocarditis (IE) remains even in our days a serious condition associated with high mortality. The need of a multidisciplinary team approach is now well known. Conservative therapy consists in high doses of antibiotics administered intravenously during 4, or 6 weeks. Dual therapy, medical and surgical may be the future attitude in endocarditis. The importance of early surgery was emphasized in contemporary literature even if some discrepancies appear in evidence-based data due to a not uniform data collection and to statistical methods. There are evidences today that the patient outcome may be improved by early surgery in few selected condition. Those are heart failure, uncontrolled infection and high risk for embolic events. IE patients with those complications are candidate to dual therapy, medical and surgical. There is no reason to delay surgical removal of infection except very large hemorrhagic and sometimes ischemic stroke. Cerebral complications delays only the intervention and do not contraindicate it. Patient appreciated as suitable for medical therapy only need regularly monitoring of clinical, biological and echocardiography parameters. Controlled randomized trials are needed to establish clearly the selection criteria for early surgery and the proper timing for that. The purpose of this paper is to emphasis the importance of optimal therapeutic strategy for patients with infective endocarditis.