From: Right-sided infective endocarditis with coronary sinus vegetation
1. Patients with persistent infection who do not respond to antibiotic therapy beyond 2 weeks, except for specific pathogens that aggressive treatment should be considered early in the course of the disease (e.g. Staphylococcus aureus, Gram negative fungi); Perivalvular extension: abscesses, fistulas. | |
2. Patients with recurrent septic pulmonary emboli, confirmed by computed tomography pulmonary angiogram. | |
3. Patients with massive or worsening tricuspid regurgitation (> 2+/4+) contributing to deteriorating right (and subsequently impending left) ventricular heart failure; evaluated by echocardiography. | |
4. Patients in septic shock and documented right-sided IE (indication for emergency operation). | |
5. When the size of a vegetation increases or persists in spite of antibiotic management at > 10 mm. | |
6. New-onset acute or worsening renal and/or hepatic failure. | |
7. Patients with right-sided IE who develop a secondary (right- or left-sided) valve endocarditis (multivalvular involvement). | |
8. Following failure or complications of percutaneous removal of infected intracardiac wires. | |
9. Complicated prosthetic valve IE: Caused by Staphylococcus aureus. |