Valve Replacement in Active Bacterial Endocarditis

ALTHOUGH the immediate mortality in patients with infective endocarditis has been dramatically reduced in the past two decades by the introduction of a number of antibiotics,1 valvular damage develops in a significant number of patients, who die within a few weeks of cardiac failure secondary to severe valvular insufficiency.2 In recent years the incidence of valvular perforations appears to have increased according to a review of autopsy findings by Robinson and Ruedy3 that showed an increase in the perforation rate in endocarditis from 15 per cent in the 1930's to 44 per cent in the 1950's. In their series 70 . . .