Surgical treatment for infective endocarditis--decision tree for the treatment and introduction of translocation method.

Persistent fever during active-phase IE is an indication for surgical treatment in the light of the causative organism and the underlying disease. To counter worsening hemodynamics, surgery may be the only feasible way. Surgery is performed when the patient does not respond to vasodilators and he shows an FS of less than 25%. The introduction of translocation provides a solution for the treatment of active IE. Lesions, vegetations more than 5 mm in diameter, periannular abscess, and mycotic aneurysm that could never be overlooked by two-dimensional echocardiography may hasten the early-stage decision of ways to treat IE.