{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T03:20:50Z","timestamp":1770088850773,"version":"3.49.0"},"reference-count":25,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI22\/00459"],"award-info":[{"award-number":["PI22\/00459"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Prosthetic valve endocarditis (PVE) carries a high morbidity and mortality. Surgery is classically indicated for heart failure, uncontrolled infection, or prevention of embolic events; however, evidence supporting surgery for \u201cnon-classical\u201d indications\u2014such as Staphylococcus aureus infection, non-HACEK Gram-negative bacteria, or early PVE\u2014remains limited. This study aimed to update the clinical and prognostic profile of PVE and assess the impact of surgery, particularly in patients with non-classical surgical indications. Methods: We prospectively included all definite left-sided PVE cases diagnosed between 2000 and 2024 at three tertiary centers. Clinical, microbiological, echocardiographic, and prognostic data were analyzed and compared. Predictors of in-hospital mortality were identified using multivariable logistic regression, and Kaplan\u2013Meier curves were used to compare 1-year survival according to surgical indications. Results: Among 589 patients with left-sided PVE, 61% underwent surgery, and in-hospital mortality was 31%. Independent mortality predictors were chronic obstructive pulmonary disease, pulmonary hypertension, periannular complications, S. aureus infection, and poor clinical condition at admission. Non-classical surgical indications were present in 38% of patients, although only 28 (5%) of them had no other surgical indication. These patients exhibited lower mortality (14%) and no survival benefit from surgery (10% vs. 17%; p 0.999). Conclusions: PVE remains associated with high mortality. Surgery improves survival in patients with classical surgical indications but not in patients with non-classical indications, supporting individualized surgical decisions by a multidisciplinary endocarditis team.<\/jats:p>","DOI":"10.3390\/diagnostics16030426","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:12:46Z","timestamp":1770041566000},"page":"426","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Profile of a Series of Left-Sided Prosthetic Valve Endocarditis: Revisiting Surgical Indications"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3951-129X","authenticated-orcid":false,"given":"Adri\u00e1n Lozano","family":"Ib\u00e1\u00f1ez","sequence":"first","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto de Ciencias del Coraz\u00f3n (ICICOR), Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6193-629X","authenticated-orcid":false,"given":"Javier L\u00f3pez","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto de Ciencias del Coraz\u00f3n (ICICOR), Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Valladolid (IBioVALL), 47010 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda de Miguel","family":"\u00c1lava","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto de Ciencias del Coraz\u00f3n (ICICOR), Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonzalo","family":"Cabez\u00f3n Villalba","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto de Ciencias del Coraz\u00f3n (ICICOR), Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Valladolid (IBioVALL), 47010 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9793-6718","authenticated-orcid":false,"given":"Andrea","family":"O\u00f1a Orive","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto de Ciencias del Coraz\u00f3n (ICICOR), Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6446-7748","authenticated-orcid":false,"given":"Daniel","family":"G\u00f3mez-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8191-4769","authenticated-orcid":false,"given":"Patricia","family":"Land\u00edn","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"P\u00e9rez-Camargo","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sof\u00eda","family":"Campillo","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto de Ciencias del Coraz\u00f3n (ICICOR), Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itziar","family":"G\u00f3mez-Salvador","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto de Ciencias del Coraz\u00f3n (ICICOR), Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Valladolid (IBioVALL), 47010 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"S\u00e1ez","sequence":"additional","affiliation":[{"name":"Secci\u00f3n de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario de la Princesa, Instituto de Investigaci\u00f3n Sanitaria del H.U. Princesa (IIS-IP), 28006 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9544-0508","authenticated-orcid":false,"given":"Carmen","family":"Olmos","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Facultad de Medicina, Salud y Deportes, Universidad Europea de Madrid, 28670 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isidre","family":"Vilacosta","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"},{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Department of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0764-0839","authenticated-orcid":false,"given":"J. Alberto","family":"San Rom\u00e1n","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto de Ciencias del Coraz\u00f3n (ICICOR), Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Valladolid (IBioVALL), 47010 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1016\/j.jacc.2024.01.037","article-title":"The Clinical Challenge of Prosthetic Valve Endocarditis: JACC Focus Seminar 3\/4","volume":"83","author":"Cuervo","year":"2024","journal-title":"J. Am. Coll. 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Med."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/3\/426\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:27:53Z","timestamp":1770042473000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/3\/426"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":25,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["diagnostics16030426"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16030426","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,1]]}}}