Surgical techniques in prosthetic valve endocarditis.

Annular extension of the infectious process is common in prosthetic valve endocarditis and carries a substantial prognostic significance in determining the immediate and late results of the surgical treatment of prosthetic valve endocarditis. Advanced destruction of the annular tissues requires complex reparative techniques for treatment. The cardiac surgeon faces the challenge of removing all infected tissues while preserving and restoring the functional integrity of the ventricular inlet and outlet. Familiarity with a growing number of specialized techniques is necessary for effective surgical treatment of these destructive lesions. This article is a synopsis of surgical techniques that we have found useful in the treatment of extensive annular destruction in bacterial endocarditis.