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Randomised controlled trial
Early surgery in infective endocarditis with large vegetations significantly reduced mortality compared with conventional treatment
  1. Marie-Christine Herregods1,
  2. Paul Herijgers2
  1. 1Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
  2. 2Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
  1. Correspondence to : Marie-Christine Herregods
    Department of Cardiovascular Diseases, University Hospitals Leuven, Herestraat, 49—box 7003, Leuven 3000, Belgium; Marie-Christine.Herregods{at}

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The treatment of infective endocarditis (IE) is still a challenge. Despite the availability of transoesophageal echocardiography which enables earlier diagnosis, and the use of appropriate antibiotics, the death rate remains high (20%). The reasons are that the population continues to become older with more comorbidities and more aggressive microorganisms like Staphylococcus aureus and Enterococcus faecalis are more frequently responsible for IE. These microorganisms induce more tissue destruction in a short time, leading to severe heart valve dysfunction early in the course of the disease. This evolution necessitates valve surgery, according to the 2006 ACC/AHA1 and 2009 ESC guidelines.2 However, the issue is the timing of surgery. Every delay in surgery compromises the final result. However, there may be …

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  • Competing interests None.