The surgical management of bacterial valvular endocarditis

Bacterial endocarditis is an important cause of cardiac valvular problems. The diagnosis of bacterial endocarditis can be difficult, and, often, an ag gressive clinical evaluation including serial blood cultures is necessary. The pathophysiology of endocarditis is changing with the rise of intravenou s drug use; staphylococci are an increasingly common cause, Endocarditis of ten warrants surgical intervention. Operations for bacterial endocarditis r ange from valve repair to valve replacement to homograft replacement. The o perations are technically challenging, but new methods of myocardial protec tion have markedly improved the surgical outcomes. Valve excision is an opt ion for intravenous drug users with tricuspid valve endocarditis, Surgical management of endocarditis is a technically challenging but rewarding proce dure that should be offered to appropriate patients. Lippincott Williams & Wilkins, Inc.