Article In Press | Published on: April 10, 2026
Volume: 2, Issue: 1
1. Department of Cardiology, Hitit University Erol Olçok Education and Research Hospital, Corum, Turkey.
2. Department of Cardiology, Faculty of Medicine, Hitit University, Corum, Turkey.
3. Department of Cardiology, Faculty of Medicine, Muğla University, Muğla, Turkey.
4. Department of Cardiology, Gediz State Hospital, Kütahya, Turkey.
Corresponding Author: Macit Kalçik, Department of Cardiology, Faculty of Medicine, Hitit University, Corum, Turkey.
Citation: Ömer B. Çelik, M. Kalçik, A. Sarihan, O. Çelik, Mehmet M. Yilmaz, et al. (2026). Surgical Timing in Infective Endocarditis: Determinants and Clinical Implications. Journal of Surgical Case Reports and Research, 2(1).
Copyright: © 2026 Macit Kalçık, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Infective endocarditis remains associated with substantial morbidity and mortality despite advances in antimicrobial therapy and imaging techniques. Surgical intervention is required in nearly half of affected patients; however, determining the optimal timing of surgery continues to represent a major clinical challenge. The decision is influenced not only by infection control but also by the dynamic progression of structural damage, embolic risk, and hemodynamic compromise. Ongoing valvular destruction may lead to acute regurgitation and heart failure, while extension of infection beyond the valve can result in abscess formation or fistulous communication, both of which are associated with poor outcomes if intervention is delayed. Vegetation size, mobility, and location play critical roles in embolic risk stratification, and early surgery may reduce the likelihood of recurrent embolic events in high-risk patients. Neurological complications further complicate decision-making, as ischemic stroke may allow timely intervention in selected cases, whereas intracranial hemorrhage often necessitates postponement. Prosthetic valve involvement represents a particularly aggressive form of disease due to biofilm formation and a higher propensity for perivalvular extension. Optimal management therefore requires integration of clinical status, imaging findings, and neurological assessment. A multidisciplinary approach has emerged as an essential strategy to guide individualized surgical timing and improve outcomes. Early intervention, when appropriately selected, may prevent irreversible structural damage and systemic complications.
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