A. Heart failure
B. Unctrontrolled infection
C. Prevention of embolism
A. HEART FAILURE:
Aortic or mitral IE with severe acute regurgitation or valve obstruction causing refractory pulmonary oedema or cardiogenic shock. |
| Timing |
Class |
Level |
| Emergency |
I |
B |
| A. Aortic or mitral IE with fistula into a cardiac chamber or pericardium causing refractory pulmonary oedema or cardiogenic shock. |
| Timing |
Class |
Level |
| Emergency |
I |
B |
| A. Aortic or mitral IE with severe acute regurgitation and persisting HF or echocardiographic signs of poor hemodynamic tolerance. |
| Timing |
Class |
Level |
| Urgent |
I |
B |
B. UNCTRONTROLLED INFECTION:
Locally uncontrolled infection. |
| Timing |
Class |
Level |
| Urgent |
I |
B |
| B. Persisting fever and positive blood culture > 7-10 days. |
| Timing |
Class |
Level |
| Urgent |
I |
B |
| B. Infection caused by fungi or multiresistant organisms. |
| Timing |
Class |
Level |
| Urgent/ elective |
I |
B |
C. PREVENTION OF EMBOLISM:
Aortic or mitral IE with large vegetations (>10 mm) following one or more embolic episodes, despite appropriate antibiotic treatment. |
| Timing |
Class |
Level |
| Urgent |
I |
B |
| C. Aortic or mitral IE with large vegetations (10 mm) and other predictors of complicated course (HF, persistent infection, abscess). |
| Timing |
Class |
Level |
| Urgent |
I |
C |
| C. Isolated very large vegetations (>15 mm). |
| Timing |
Class |
Level |
| Urgent |
IIb |
C |