When is emergency IE surgery (<24h) indicated?

Emergency IE surgery within 24h: severe AR/MR with refractory pulmonary edema or cardiogenic shock, valve obstruction causing hemodynamic compromise, or large vegetation causing recurrent major emboli.

When is urgent IE surgery (1-7 days) indicated?

Urgent surgery within 1-7 days: heart failure NYHA III-IV, uncontrolled infection (perivalvular extension, fungal, resistant organisms), and large vegetation >10mm at high embolic risk.

Can surgery proceed with recent stroke?

Surgery is not contraindicated by minor or silent cerebral emboli. Major ischemic stroke without hemorrhage: surgery may proceed after 72h. Hemorrhagic transformation requires waiting 2-4 weeks if hemodynamically stable.

IE Surgery Timing ERAS Protocol

Determine optimal timing for infective endocarditis surgery using ESC/ACC/AHA indication classes. Emergency (<24h), urgent (<7 days), or elective (>7 days) timing based on complications.

Use the full interactive calculator below, or

Related Calculators

IE EuroSCORE Perioperative Risk

Hyper-niche Medical

Duke IE Criteria 2023