Indications and Timing of Surgery (Including Indications for Extra-Cardiac Infectious Foci)

Appropriate surgery plays a vital role in the effective management of infective endocarditis. The indications for surgical management often differ, depending on the subtype of infective endocarditis (native valve versus prosthetic valve infective endocarditis, left-sided versus right-sided infective endocarditis, infective endocarditis associated with cardiovascular implantable electronic devices). Due to the complex nature of the disease, optimal management and appropriate decision-making regarding the need and timing of surgery should ideally be evaluated by an experienced multidisciplinary endocarditis team, consisting of expert cardiothoracic surgeons, infectious diseases physicians, and experienced cardiovascular imaging physicians. This chapter provides a contemporary review of the current indications for surgical management of infective endocarditis, drawing on the current literature and contemporary guidelines.