Describe Surgical Treatment prosthetic valve endocarditis ?
If there is definite indication for early surgery, the current understanding is to proceed with valve replacement irrespective of the duration of antibiotic treatment. Previously it was thought that surgery should be postponed till the patient has been cured by antibiotics or postpone it as long as possible to suppress bacteremia as much as possible.
In case of prosthetic valve endocarditis, surgery is undertaken earlier. Emergency operation is required for acute aortic regurgitation with mitral valve pre-closure, sinus of Valsalva rupture into heart chamber or pei-icardiuin. Less urgent surgery required for valve obstruction, unstable prosthesis, AR or MR with heart failure, septa1 perforation and perivalvar extension of infection. When a patient has sustained cerebral embolism, if possible it is better to wait for a month, as risk of cerebral haemorrhage during open-heart surgery is as high as 20 to 44 per cent.