Surgical aspects of bacterial endocarditis.

Forty patients with a previous history of bacterial endocarditis were treated surgically between December 1967 and August 1971. Of 28 patients who had elective valve replacements there were four hospital deaths and one late death. Seven patients underwent emergency operation for intractable heart failure before completion of antibiotic treatment, six survived operation and there was one late death. Six patients had operations for infection on pre-existing valve substitutes, of whom three were treated as emergencies. There were two hospital and no late deaths. 78% of all patients were alive and well four years to nine months after operation.These results confirm that in addition to elective valve replacement surgery has an important role both in the treatment of intractable heart failure during the infective stage of bacterial endocarditis and in the eradication of infection on cardiac prostheses.