Preoperative Checklist in Endocarditis Patients

Infective endocarditis is a complex disease process requiring multidisciplinary diagnosis, treatment, and management. When surgical treatment is indicated, the anesthesiologist’s role begins with a thorough preoperative evaluation. A general understanding of the disease process, diagnosis, and treatments that may be initiated preoperatively provide an important background for preoperative evaluation. The patient’s test results, preoperative consults, and imaging studies should be reviewed for information relevant to perioperative management. Any non-cardiac systemic involvement and co-existing conditions should be included in the evaluation. Planning for re-operative cardiac surgery and high-risk anatomical features, such as pseudoaneurysm or abscess formation, should be discussed with the surgical team. Finally, a post-operative pain management plan should be discussed. This plan should include consideration of the need to continue any ongoing treatment for underlying addiction in patients with infective endocarditis related to substance use disorder.