Early Outcomes of Surgical Treatment for Infective Endocarditis: A Single-Center Retrospective Analysis of 200 Patients

Highlights Infective endocarditis (IE) is associated with a high incidence of valvular destruction, heart failure, and systemic complications, emphasizing the importance of timely surgical intervention in specialized cardiac surgery centers. In this single-center study, the majority of patients required multivalve reconstructive or valve replacement procedures, reflecting the severity of structural valve damage associated with IE. Despite the complexity of the disease and the extensive nature of surgical interventions, the findings confirm the pivotal role of surgery in achieving infection control and correcting intracardiac complications in patients with infective endocarditis. Aim. To evaluate the early outcomes of surgical treatment for IE and to assess the structure of postoperative complications in patients undergoing surgery at a specialized cardiac surgery center. Methods. A single-center retrospective study included 200 consecutive patients with IE who underwent surgical treatment between 2013 and 2025. Clinical and demographic characteristics, echocardiographic findings, surgical variables, and early postoperative outcomes were analyzed. The primary endpoints were in-hospital mortality and postoperative complications. Results. The median age of the patients was 48 (38–63) years, and 75% were male. The most common indications for surgery were decompensated chronic heart failure (68.5%), uncontrolled infection (20.5%), and embolic events (15.5%). Vegetations were detected in 98% of patients, with a maximal size greater than 10 mm in 78% of cases. Valvular abscesses were identified in 16% of patients. Multivalve procedures were performed in 87% of cases, while valve replacement was required in 75.5% of patients. The median operative time was 190 (158–230) minutes, cardiopulmonary bypass time was 93.5 (76.8–118.3) minutes, and aortic cross-clamp time was 74 (60–91) minutes. In-hospital mortality was 22%. The most frequent postoperative complications included the need for inotropic or vasopressor support (44%), cardiovascular failure (38%), acute kidney injury (30.6%), respiratory failure (25.5%), postoperative atrial fibrillation (23%), sepsis (20%), and multiple organ dysfunction syndrome (22%). Stroke occurred in 5% of patients. Conclusions. Patients undergoing surgery for infective endocarditis are characterized by a high prevalence of valvular destruction, heart failure, and systemic complications. Despite the severity of the disease and the complexity of surgical procedures, surgery remains the cornerstone of treatment, providing control of the infectious process and correction of intracardiac lesions. Early outcomes are determined not only by surgical factors but also by disease severity at the time of intervention, highlighting the importance of timely diagnosis and early referral to specialized cardiac surgery centers.