Surgery for infections

Infective endocarditis, both native and prosthetic, is ultimately a fatal illness without therapy, reflecting the inability of innate defenses to importantly influence the course of the disease.Following the diagnosis, the therapy of this illness depends on identification of the organism, administration of bactericidal antibiotics and the use of timely cardiac surgical intervention in patients with complications such as heart failure from valvular destruction, annular abscess formation, uncontrolled sepsis and embolization. This chapter deals with one aspect of the therapy of infective endocarditis, namely the role of homograft valves in the reconstruction of the infected aortic root and will only deal with the pathology of the infected aortic root and surgical details that are of relevance to the insertion of homograft valves.