Dr. Stephen Green, chief of cardiology at North Shore University Hospital in Manhasset, N.Y., said that the new findings only apply to a select few. "Patients in the study had very large vegetation and severe valve pathology," Green said. "These tend to be the worst of the worst."
Most people with infective endocarditis are treated with antibiotics. "We reserve surgery for people whose infections don't resolve, have fever or bacteria in the bloodstream or whose valves get destroyed," Green noted.
"Many people with milder forms can be treated with antibiotics and monitored long term to see if they need surgery," he added. This study suggests that "if you get a really bad clump of stuff on a valve, even if it's antibiotic-sensitive, maybe we should go to surgery earlier."
Learn more about infective endocarditis at the American Heart Association.
SOURCES: Duk-Hyun Kang, M.D., cardiologist, University of Ulsan, Seoul, South Korea; Gosta Pettersson, M.D., Ph.D., vice chair, thoracic and cardiovascular surgery, and surgical director of lung transplantation, Cleveland Clinic, Ohio; Stephen Green, M.D., chief of cardiology, North Shore University Hospital, Manhasset, N.Y.; June 28, 2012, New England Journal of Medicine
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