Contemporary risk models for infective endocarditis surgery: a narrative review

Abstract

Infective endocarditis is a complex heterogeneous condition involving the infection of the endocardium and heart valves, leading to severe complications, including death. Surgery is often indicated in patients with infective endocarditis but is associated with elevated risk compared with other forms of cardiac surgery. Risk models play an important role in many cardiac surgeries as they can help inform clinicians and patients regarding procedural risk, decision-making to proceed or not, and influence perioperative management; however, they remain under-utilized in the infective endocarditis settings. Another crucial role of such risk models is to assess predicted versus found mortality, thereby allowing an assessment of institutional performance in infective endocarditis surgery. Traditionally, general cardiac surgery risk models such as European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II, and Society of Thoracic Surgeon’s score have been applied to endocarditis surgery. However, there has been the development of many endocarditis surgery-specific scores over the last decade. This review aims to discuss clinical characteristics and applications of all contemporary risk scores in the setting of surgical treatment of infective endocarditis.

Beyond the Valve: Incidence, Outcomes, and Modifiable Factors of Acute Kidney Injury in Patients with Endocarditis Undergoing Valve Surgery — A Retrospective, Single-Center Study

“…Valvular surgery, often required for uncontrolled infection, embolic disease or severe valvular dysfunction, aims to eradicate the infectious focus, repair or replace valves, and restore cardiac function. Valvular surgery is, therefore, integral to the comprehensive management of endocarditis, aiming not only to address the acute infectious process but also to prevent long-term complications and improve overall patient outcomes [5][6][7].…”