[The role of surgery in infectious endocarditis]

161 patients underwent an aortic valve replacement from 1966 till January 1995 for active infective endocarditIS of the native aortic valve. The disease extended to the other cardiac valves in 39 patients and to the surrounding areas in 42 (aortic root and subaortic myocardial tissues). Indications for surgery were: congestive heart failure in 123, uncontrolled sepsis in 44 and emboli in 24. Total follow-up was 1,120 patient-years with a maximum follow-up of 29 years. Early mortality was 8%; late mortality was 3.6%/patient-year; recurrence rate of endocarditis was 1.3%/patient year; survival and reoperation free curve was 68% (S.E. +/- 0.04) at 10 years. These long term results are in favour of a surgical attitude with an acceptable surgical risk without delay.