Manuela de la Cuesta, Mateo Marin-Cuartas, Suzanne de Waha, Milan Milojevic, Patrick O Myers, Martin Misfeld, Eduard Quintana, Nikolaos Bonaros, Carlos A Mestres, Torsten Doenst, Alexey Dashkevich, Philipp Kiefer, David Holzhey, Michael A Borger
{"title":"EACTS认可的2023 ESC心内膜炎指南的手术意义:衔接指南和实践","authors":"Manuela de la Cuesta, Mateo Marin-Cuartas, Suzanne de Waha, Milan Milojevic, Patrick O Myers, Martin Misfeld, Eduard Quintana, Nikolaos Bonaros, Carlos A Mestres, Torsten Doenst, Alexey Dashkevich, Philipp Kiefer, David Holzhey, Michael A Borger","doi":"10.1093/ejcts/ezaf225","DOIUrl":null,"url":null,"abstract":"<p><p>Infective endocarditis (IE) remains a challenging condition with high morbidity and mortality despite advances in diagnosis and management. The 2023 European Society of Cardiology guidelines, endorsed by the European Association of Cardio-Thoracic Surgery, introduce significant updates, including several new recommendations with regard to surgical intervention. This review synthesizes current evidence on the surgical management of IE, emphasizing indications, timing, and outcomes. The multidisciplinary Endocarditis Team approach is highlighted as a key factor in improving patient prognosis by optimizing diagnosis and treatment strategies. Advanced imaging techniques, such as positron emission tomography-computed tomography, have enhanced diagnostic accuracy, particularly for prosthetic valve endocarditis. Despite the clear survival benefits associated with surgery, only a minority of eligible patients undergo surgical treatment, underscoring the need for better patient selection and timely intervention. Furthermore, the worse prognosis is found in patients with indications for surgery who do not undergo surgical intervention. The updated IE guidelines provide detailed timing recommendations for surgery based on the clinical scenario, including new considerations for patients with stroke. Additionally, novel recommendations regarding partial oral antibiotic therapy following surgery have been introduced. Finally, important measures for the prevention of IE recurrence are discussed. In conclusion, timely surgical intervention, based on defined recommendations guided by multidisciplinary collaboration and enhanced diagnostic tools, is crucial in improving outcomes for IE patients.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Surgical implications of the 2023 ESC endocarditis guidelines endorsed by EACTS: Bridging guidelines and practice.\",\"authors\":\"Manuela de la Cuesta, Mateo Marin-Cuartas, Suzanne de Waha, Milan Milojevic, Patrick O Myers, Martin Misfeld, Eduard Quintana, Nikolaos Bonaros, Carlos A Mestres, Torsten Doenst, Alexey Dashkevich, Philipp Kiefer, David Holzhey, Michael A Borger\",\"doi\":\"10.1093/ejcts/ezaf225\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Infective endocarditis (IE) remains a challenging condition with high morbidity and mortality despite advances in diagnosis and management. The 2023 European Society of Cardiology guidelines, endorsed by the European Association of Cardio-Thoracic Surgery, introduce significant updates, including several new recommendations with regard to surgical intervention. This review synthesizes current evidence on the surgical management of IE, emphasizing indications, timing, and outcomes. The multidisciplinary Endocarditis Team approach is highlighted as a key factor in improving patient prognosis by optimizing diagnosis and treatment strategies. Advanced imaging techniques, such as positron emission tomography-computed tomography, have enhanced diagnostic accuracy, particularly for prosthetic valve endocarditis. Despite the clear survival benefits associated with surgery, only a minority of eligible patients undergo surgical treatment, underscoring the need for better patient selection and timely intervention. Furthermore, the worse prognosis is found in patients with indications for surgery who do not undergo surgical intervention. The updated IE guidelines provide detailed timing recommendations for surgery based on the clinical scenario, including new considerations for patients with stroke. Additionally, novel recommendations regarding partial oral antibiotic therapy following surgery have been introduced. Finally, important measures for the prevention of IE recurrence are discussed. In conclusion, timely surgical intervention, based on defined recommendations guided by multidisciplinary collaboration and enhanced diagnostic tools, is crucial in improving outcomes for IE patients.</p>\",\"PeriodicalId\":520617,\"journal\":{\"name\":\"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/ejcts/ezaf225\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ejcts/ezaf225","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Surgical implications of the 2023 ESC endocarditis guidelines endorsed by EACTS: Bridging guidelines and practice.
Infective endocarditis (IE) remains a challenging condition with high morbidity and mortality despite advances in diagnosis and management. The 2023 European Society of Cardiology guidelines, endorsed by the European Association of Cardio-Thoracic Surgery, introduce significant updates, including several new recommendations with regard to surgical intervention. This review synthesizes current evidence on the surgical management of IE, emphasizing indications, timing, and outcomes. The multidisciplinary Endocarditis Team approach is highlighted as a key factor in improving patient prognosis by optimizing diagnosis and treatment strategies. Advanced imaging techniques, such as positron emission tomography-computed tomography, have enhanced diagnostic accuracy, particularly for prosthetic valve endocarditis. Despite the clear survival benefits associated with surgery, only a minority of eligible patients undergo surgical treatment, underscoring the need for better patient selection and timely intervention. Furthermore, the worse prognosis is found in patients with indications for surgery who do not undergo surgical intervention. The updated IE guidelines provide detailed timing recommendations for surgery based on the clinical scenario, including new considerations for patients with stroke. Additionally, novel recommendations regarding partial oral antibiotic therapy following surgery have been introduced. Finally, important measures for the prevention of IE recurrence are discussed. In conclusion, timely surgical intervention, based on defined recommendations guided by multidisciplinary collaboration and enhanced diagnostic tools, is crucial in improving outcomes for IE patients.