{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:51:11Z","timestamp":1791874271216,"version":"4.3.4"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2015,1,13]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Use of surgery for the treatment of infective endocarditis (IE) as related to surgical indications and operative risk for mortality has not been well defined.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              The International Collaboration on Endocarditis\u2013PLUS (ICE-PLUS) is a prospective cohort of consecutively enrolled patients with definite IE from 29 centers in 16 countries. We included patients from ICE-PLUS with definite left-sided, non\u2013cardiac device\u2013related IE who were enrolled between September 1, 2008, and December 31, 2012. A total of 1296 patients with left-sided IE were included. Surgical treatment was performed in 57% of the overall cohort and in 76% of patients with a surgical indication. Reasons for nonsurgical treatment included poor prognosis (33.7%), hemodynamic instability (19.8%), death before surgery (23.3%), stroke (22.7%), and sepsis (21%). Among patients with a surgical indication, surgical treatment was independently associated with the presence of severe aortic regurgitation, abscess, embolization before surgical treatment, and transfer from an outside hospital. Variables associated with nonsurgical treatment were a history of moderate\/severe liver disease, stroke before surgical decision, and\n              <jats:italic>Staphyloccus aureus<\/jats:italic>\n              etiology. The integration of surgical indication, Society of Thoracic Surgeons IE score, and use of surgery was associated with 6-month survival in IE.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>\n              Surgical decision making in IE is largely consistent with established guidelines, although nearly one quarter of patients with surgical indications do not undergo surgery. Operative risk assessment by Society of Thoracic Surgeons IE score provides prognostic information for survival beyond the operative period.\n              <jats:italic>S aureus<\/jats:italic>\n              IE was significantly associated with nonsurgical management.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.114.012461","type":"journal-article","created":{"date-parts":[[2014,12,6]],"date-time":"2014-12-06T06:35:24Z","timestamp":1417847724000},"page":"131-140","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":250,"title":["Association Between Surgical Indications, Operative Risk, and Clinical Outcome in Infective Endocarditis"],"prefix":"10.1161","volume":"131","author":[{"given":"Vivian H.","family":"Chu","sequence":"first","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence P.","family":"Park","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Athan","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Delahaye","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Freiberger","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiane","family":"Lamas","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose M.","family":"Miro","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Mudrick","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Strahilevitz","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Tribouilloy","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Durante-Mangoni","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan M.","family":"Pericas","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Fern\u00e1ndez-Hidalgo","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Nacinovich","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussien","family":"Rizk","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Krajinovic","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efthymia","family":"Giannitsioti","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Hurley","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret M.","family":"Hannan","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer Biomedical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Wang","sequence":"additional","affiliation":[{"name":"From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic\u2013August Pi i Sunyer 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Prospective Study From the International Collaboration on Endocarditis"],"short-title":[],"issued":{"date-parts":[[2015,1,13]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,1,13]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.114.012461"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.114.012461","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,13]]},"assertion":[{"value":"2014-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-10-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-12-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}