{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:07:13Z","timestamp":1788480433012,"version":"build-2803163510"},"reference-count":76,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)"},{"name":"AbbVie"},{"name":"Angelini"},{"name":"Contrafect"},{"name":"Cubist"},{"name":"Genentech"},{"name":"Gilead Sciences"},{"name":"Jansen"},{"name":"Lysovant"},{"name":"Medtronic"},{"name":"MSD"},{"name":"Novartis"},{"name":"Pfizer"},{"name":"ViiV Healthcare"},{"name":"Edwards LifeSciences LLC"},{"name":"Cytosorbents Corpl"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In patients with infective endocarditis and neurological complications, the optimal timing for cardiac surgery is unclear due to the varied risk of clinical deterioration when early surgery is performed. The aim of this review is to summarize the best evidence on the optimal timing for cardiac surgery in the presence of each type of neurological complication. An English literature search was carried out from June 2018 through July 2022. The resulting selection, comprising observational studies, clinical trials, systematic reviews and society guidelines, was organized into four sections according to the four groups of neurological complications: ischemic, hemorrhagic, infectious, and asymptomatic complications. Cardiac surgery could be performed without delay in cases of ischemic vascular neurological complication (provided the absence of severe damage, which can be avoided with the performance of mechanical thrombectomy in cases of major stroke), as well as infectious or asymptomatic complications. In the presence of intracranial hemorrhage, a delay of four weeks is recommended for most cases, although recent studies have suggested that performing cardiac surgery within four weeks could be a suitable option for selected cases. The findings of this review are mostly in line with the recommendations of the current European and American infective endocarditis guidelines.<\/jats:p>","DOI":"10.3390\/jcm11185275","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T01:40:13Z","timestamp":1662601213000},"page":"5275","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Optimal Timing for Cardiac Surgery in Infective Endocarditis with Neurological Complications: A Narrative Review"],"prefix":"10.3390","volume":"11","author":[{"given":"Joan","family":"Siquier-Padilla","sequence":"first","affiliation":[{"name":"Cardiology Department, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7075-943X","authenticated-orcid":false,"given":"Guillermo","family":"Cuervo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Clinic\u2014IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xabier","family":"Urra","sequence":"additional","affiliation":[{"name":"Functional Unit of Cerebrovascular Diseases, Institute of Neurosciences, Hospital Clinic\u2014IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Quintana","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Department, Hospital Clinic\u2014IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Hern\u00e1ndez-Meneses","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Clinic\u2014IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Department, Hospital Clinic\u2014IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pau","family":"Lape\u00f1a","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3483-3786","authenticated-orcid":false,"given":"Carles","family":"Falces","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Clinic\u2014IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8148-9044","authenticated-orcid":false,"given":"Carlos A.","family":"Mestres","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery Department, The University of the Free State, Bloemfontein 9300, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9791-5888","authenticated-orcid":false,"given":"Alfredo","family":"Paez-Carpio","sequence":"additional","affiliation":[{"name":"Radiology Department, Diagnostic Imaging Center (CDI), Hospital Clinic\u2014IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asunci\u00f3n","family":"Moreno","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Clinic\u2014IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8057-7755","authenticated-orcid":false,"given":"Jos\u00e9 Mar\u00eda","family":"Miro","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Clinic\u2014IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.gheart.2014.01.002","article-title":"Global and regional burden of infective endocarditis, 1990\u20132010: A systematic review of the literature","volume":"9","author":"Baddour","year":"2014","journal-title":"Glob. 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