Surgery for prosthetic valve endocarditis

Infectious endocarditis is the main complication after prosthetic valvular replacement. 2 problems remain unsolved: 1. Diagnostic: Fever, heart failure and paravalvular leaks should be indications for re-operations. 2. Technical: perfect fixation of the prosthetic valve is a surgical challenge. The difficulties as shown here are the cause for so many operative techniques. Early surgical intervention is the best method to prevent myocardial failure.