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No randomized trials have been conducted to examine the role and timing of valve surgery in patients with prosthetic valve endocarditis (PVE). This aspect of endocarditis management is critical and is being used more today than in the past. Now, International Collaboration on Endocarditis–Prospective Cohort Study investigators have examined data prospectively collected between 2000 and 2006 from 64 medical centers in 28 countries to evaluate in-hospital and 1-year mortality rates for PVE patients who did or did not undergo early valve replacement or repair.
Of the 1025 patients in the study cohort, 490 (47.8%) underwent early (during the initial hospitalization for PVE) surgery. After adjustment for treatment-selection and survivor biases, s…