{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:42:11Z","timestamp":1791646931694,"version":"4.3.4"},"reference-count":22,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Acute aortic valve infective endocarditis (IE) presents a critical surgical timing dilemma. This study investigates whether early surgical intervention (within seven days of targeted antibiotic therapy initiation) affects mortality and clinical outcomes compared to delayed\/conventional surgery. Methods: A retrospective, multicenter analysis of 204 patients with aortic IE was conducted, excluding emergency cases requiring immediate intervention. Patients were stratified into EARLY (\u22647 days) and LATE (&gt;7 days) surgical groups. Primary endpoints included in-hospital mortality and major adverse events, while secondary endpoints assessed long-term survival, recurrence, and reintervention rates. Results: No significant differences in in-hospital mortality were observed between groups (16% in both). The LATE group exhibited a trend toward increased permanent pacemaker implantation (16% vs. 8.2%; p = 0.100) and a higher incidence of postoperative atrial fibrillation (36% vs. 24%, p = 0.048). Infective endocarditis recurrence and long-term survival did not significantly differ between groups. Predictors of one-year mortality included chronic kidney disease, annular abscess, extracorporeal membrane oxygenation (ECMO) use, and prolonged mechanical ventilation. Conclusions: These findings suggest that early surgery, following a short course of antibiotics, does not compromise outcomes nor increase recurrence risk, challenging the conventional preference for delayed intervention in non-emergency IE cases.<\/jats:p>","DOI":"10.3390\/jcdd12040153","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T03:39:16Z","timestamp":1744601956000},"page":"153","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Dilemma of Surgical Timing in Acute Aortic Valve Endocarditis: Does Early Surgery Improve Risks or Prognosis?"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3971-4145","authenticated-orcid":false,"given":"Michele","family":"D\u2019Alonzo","sequence":"first","affiliation":[{"name":"Cardiac Surgery Unit, University of Brescia, \u201cSpedali Civili\u201d Hospital, 25124 Brescia, Italy"},{"name":"Cardiac Surgery Unit, H\u00f4pital \u201cHenri Mondor\u2014Assistance Publique H\u00f4p\u00eetaux de Paris\u201d, 94100 Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Di Bacco","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, University of Brescia, \u201cSpedali Civili\u201d Hospital, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7962-7276","authenticated-orcid":false,"given":"Antonio","family":"Fiore","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, H\u00f4pital \u201cHenri Mondor\u2014Assistance Publique H\u00f4p\u00eetaux de Paris\u201d, 94100 Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3754-6704","authenticated-orcid":false,"given":"Massimo","family":"Baudo","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8838-6030","authenticated-orcid":false,"given":"Francesca","family":"Zanin","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, University of Brescia, \u201cSpedali Civili\u201d Hospital, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Baldelli","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery, University of Brescia, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus","family":"Moini","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Groupe Hospitalier Sud Ile de France, 77000 Melun, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0009-6543","authenticated-orcid":false,"given":"Thierry","family":"Folliguet","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, H\u00f4pital \u201cHenri Mondor\u2014Assistance Publique H\u00f4p\u00eetaux de Paris\u201d, 94100 Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2656-4544","authenticated-orcid":false,"given":"Claudio","family":"Muneretto","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, University of Brescia, \u201cSpedali Civili\u201d Hospital, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/S0140-6736(15)00067-7","article-title":"Infective Endocarditis","volume":"387","author":"Cahill","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/S0140-6736(14)62007-9","article-title":"Incidence of Infective Endocarditis in England, 2000\u20132013: A Secular Trend, Interrupted Time-Series Analysis","volume":"385","author":"Dayer","year":"2015","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3075","DOI":"10.1093\/eurheartj\/ehv319","article-title":"2015 ESC Guidelines for the Management of Infective Endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM)","volume":"36","author":"Habib","year":"2015","journal-title":"Eur. 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