24th June 2026

Surgical Management

Indications for surgical management in IE are:

• Heart failure
  • Left-sided IE causing heart failure; severe valve regurgitation with no heart failure
  • Right-sided IE: tricuspid regurgitation causing heart failure that is refractory to medical therapy
• Infection
  • Persistent bacteraemia despite adequate antimicrobial therapy
  • Formation of an abscess, false aneurysm, or enlarging vegetation
  • Fungal infection or infection with multi-resistant organism
• Prevention of embolic complications
  • Left-sided IE with large vegetations (>10mm) resulting in one or more embolic episodes despite appropriate antimicrobial therapy
  • Isolated vegetations >15mm