Infective endocarditis surgery is for people with severe heart valve infections. Various procedures clear away bacteria and fungus and repair damaged heart valves. For the majority of people, surgery is the only option for preventing heart failure and other life-threatening complications.
This condition occurs when fungus or bacteria enter your bloodstream and attack heart valve tissue, usually after invasive procedures like dental work or endoscopy. Normal heart valve tissue is naturally resistant to infection. But diseased valves have defects that make it easier for infections to occur.
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Infective endocarditis can be due to many types of fungus or bacteria. Without treatment, these organisms multiply and form colonies (mass-like lesions on your heart valves called vegetations).
Vegetations produce enzymes that destroy healthy heart valve tissue, causing valve dysfunction like a leaky valve. This raises your risk of developing heart failure. If a clump breaks off (embolus) from a vegetation, it can travel through your bloodstream and block blood vessels. This can lead to life-threatening complications, like stroke and pulmonary embolism or interruption of blood flow (ischemia) to an abdominal organ or extremity.
Treatment depends on the type of fungus or bacteria causing the infection and its severity. When caught in earlier stages, antibiotics can be effective. When there are vegetations, damage to the heart valve or an infected prosthetic valve, surgery is often necessary.
Surgery helps by:
The timing of your procedure depends on how sick you are. In up to 30% of patients, it’s best to perform surgery within days of diagnosis. This is especially true in patients with replacement valves that become infected.
Other valve-related issues that may require urgent surgery include:
Additional considerations for urgent surgery include complications like:
The other reason to delay surgery is when the infection is not severe and the complication risk isn’t high. This enables people to take the entire course of antibiotics and go into surgery infection-free. It also enables surgeons to plan the most appropriate procedure for your needs. Healthcare providers use this approach in 20% to 40 % of cases.
A small number of individuals might not be healthy enough for surgery. These include:
Healthcare providers follow established guidelines for the management of endocarditis. Additionally, healthcare providers use various assessments to determine whether you need surgery. They also help surgeons plan your procedure and determine whether it was successful.
The appropriate procedure for your needs depends on the type and severity of heart valve damage. Surgery may include:
Once your healthcare provider determines that you need surgery for infective endocarditis, there’s no alternative. The results of the procedure include:
Potential risks include:
You can expect to stay in the intensive care unit for the first few days of your recovery, then you go to the regular hospital floor. Providers will continuously monitor your heart in the early stages to check for signs of complications. You may need to stay on antibiotics (oral or intravenous) for several weeks after surgery to eradicate any remaining infection. Once you get home, you’ll need to take it easy. It’s natural to feel tired and sore during this time. Recovery may take longer if you were severely ill before your procedure.
Having surgery doesn't guarantee a successful recovery. In some cases, vegetations come back after treatment. Some patients continue having health issues due to complications.
The prognosis is better for people who undergo surgery before valve tissue damage and other complications occur. Prognosis is not as good for people who end up with heart failure.
After infective endocarditis surgery, contact your healthcare provider if you have:
A note from Cleveland Clinic
Infective endocarditis surgery is for people with difficult-to-treat heart valve infections. A variety of techniques may be necessary, including heart valve repair or replacement. Seeing a surgeon who’s experienced in infective endocarditis surgery gives you the best chances of achieving good results.
Last reviewed by a Cleveland Clinic medical professional on 04/11/2022.
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