Surgery for Infective Endocarditis in Patients on Hemodialysis

Patients with end-stage renal disease on hemodialysis (HD) are at increased risk for developing infective endocarditis (HD). These patients are at increased risk compared to nonhemolysis patients when undergoing surgery for IE and have higher perioperative mortality compared to non-HD patients. The intermediate- and long-term survival are significantly worse for HD compared to non-HD patients but only slightly worse than the general HD population; however, it is significantly better than HD patients managed nonsurgically. Choice of prosthetic valve (mechanical or biologic) does not impact short- and long-term outcomes. While HD patients with IE constitute a sicker patient population with poorer operative outcomes, surgery should be considered due to significantly poor outcomes associated with nonsurgical management.