Evaluating the Severity of Valvular Involvement

In the first place, the type of IE should be considered as to whether it is native valve endocarditis (NVE) or prosthetic valve endocarditis (PVE). The latter is associated with more severe complications, operative technical difficulties, and less favorable results compared to NVE. Surgical results are also better for an initial IE episode than for recurrent IE.

All valves and related structures should be assessed to determine the involved valves, extent of disease (e.g., annular involvement), and presence of intracardiac complications (i.e., abscesses, aneurysm/pseudo-aneurysm, fistula, aortoventricular/atrioventricular discontinuity, etc.). Such complications constitute independent risk factors with adverse impact on operative outcomes and survival.

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