Related Experiment Video
Updated: Jan 8, 2026
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Cardiac surgery timing on the prognosis of patients with infective endocarditis
Wu Liu1,2, Yongqin Li1,2, Heng Yang1,2
1Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, P. R. China.
Background:
Infective endocarditis (IE) is a disease caused by the involvement of pathogenic microorganisms in the endocardium, primarily characterized by the formation of growths and progressive valve damage. Despite advances in diagnostic and therapeutic methods, the mortality rate remains high. Conventional treatment typically favors surgery after 4-6 weeks of infection control. Although a series of articles on early surgical treatment have been published in recent years, outcomes for early surgical treatment continue to vary.
Methods:
By collecting the clinical data of 166 patients who underwent cardiac surgery for IE between February 1, 2017, and January 31, 2023, we classified the patients into three groups: Group A (radical surgery within 1-7 days after admission), Group B (surgical treatment 8-13 days after admission), and Group C (surgical treatment 14-28 days after admission) according to different treatment strategies. To compare the effects of different times of surgical intervention on the early prognosis of patients, logistic multivariate regression analysis was used to determine the risk factors associated with surgical mortality, and the survival of different groups of patients was compared using Kaplan-Meier survival analysis.
Results:
The results showed no significant differences in perioperative reinfarction, endocarditis recurrence, heart failure, or in-hospital mortality among the three treatment groups. However, ICU length of stay (P=0.015, 1.30 [1.05-1.61]), cardiac malfunction (P=0.015, 22.28 [1.82-273.04]), and other organ malfunctions (P=0.007, 29.21 [2.46-346.49]) were identified as risk factors affecting patient mortality.
Conclusions:
Early surgical intervention did not increase the risk of death in patients with IE, nor did it increase the risk of recurrence and reoperation within one year. Therefore, we recommend early surgical intervention before completing a cycle of antibiotics in patients with a clear diagnosis, unstable cardiac function, or risk of recurrent embolism.
Insights
Early cardiac surgery for infective endocarditis (IE) does not increase mortality or recurrence risk. This study recommends timely surgical intervention for IE patients with unstable conditions, even before antibiotic completion.
Area of Science:
- Cardiology
- Cardiac Surgery
- Infectious Diseases
Background:
- Infective endocarditis (IE) involves microbial infection of the heart's inner lining, causing progressive valve damage and high mortality.
- Conventional IE treatment often delays surgery until after 4-6 weeks of infection control, with variable outcomes for early intervention.
- Despite advances, IE management remains challenging, necessitating research into optimal surgical timing.
Purpose of the Study:
- To evaluate the impact of different surgical intervention timings on the early prognosis of patients with infective endocarditis.
- To compare the outcomes of radical surgery within 1-7 days, 8-13 days, and 14-28 days after admission for IE.
Main Methods:
- A retrospective analysis of 166 patients who underwent cardiac surgery for IE between February 2017 and January 2023.
- Patients were categorized into three groups based on surgical timing: 1-7 days (Group A), 8-13 days (Group B), and 14-28 days (Group C).
- Logistic multivariate regression and Kaplan-Meier survival analysis were employed to identify risk factors for surgical mortality and compare survival rates.
Main Results:
- No significant differences in perioperative reinfarction, IE recurrence, heart failure, or in-hospital mortality were observed among the three surgical timing groups.
- Increased ICU length of stay, cardiac malfunction, and other organ malfunctions were identified as significant risk factors impacting patient mortality.
- Early surgical intervention (1-7 days) did not correlate with increased adverse events compared to later surgical strategies.
Conclusions:
- Early surgical intervention for infective endocarditis does not elevate the risk of death, recurrence, or reoperation within one year.
- The study recommends considering early surgical intervention for IE patients with clear diagnoses, unstable cardiac function, or embolism risk, prior to completing antibiotic therapy.
- Timely surgical management can be a safe and effective strategy for select IE patients, potentially improving outcomes.
Related Concept Videos
01:18Endocarditis III: Medical Management
01:25Endocarditis I: Introduction
01:29Endocarditis IV: Nursing Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:14Myocarditis III: Medical Management
01:25Endocarditis II: Clinical Features of Infective Endocarditis