Bacterial endocarditis with aortic regurgitation: implications of embolism.

We studied 16 patients with 18 episodes of bacterial endocarditis and aortic regurgitation to learn the frequency and characteristics of systemic embolism. Seven patients had eight episodes of clinically apparent emboli, with a mortality of 43%; in those without emboli there was no mortality. The influences of congestive heart failure, type of infection, and echocardiographic findings on the embolic complications are discussed. The close association among embolism, congestive heart failure, and echocardiographic vegetation suggests that early operation is warranted in patients with any of these features in order to prevent emboli.