Review articlesProsthetic valve endocarditisNataloni, Maura; Pergolini, Martina; Rescigno, Giuseppe; Mocchegiani, RobertoAuthor Information aOutpatient Cardiology Service, Zona 6, Asur Marche, Fabriano Hospital, Italy bCardiology Division, Jesi Hospital, Italy cCardiac Surgery Department, Presidio Lancisi, Ospedali Riuniti, Italy dCardiology Department, Presidio Lancisi, Ospedali Riuniti, Ancona, Italy Received 3 July, 2009 Revised 10 December, 2009 Accepted 18 December, 2009 Correspondence to Roberto Mocchegiani, MD, Cardiology Department, Presidio Lancisi, Ospedali Riuniti, Via Tommasi 5, 60124 Ancona, Italy Tel: +39 071 596 5011; fax: +39 071 870 5276; e-mail: [email protected] Journal of Cardiovascular Medicine: December 2010 - Volume 11 - Issue 12 - p 869-883 doi: 10.2459/JCM.0b013e328336ec9a Buy Metrics Abstract Prosthetic valve endocarditis (PVE) is associated with a high mortality during the early and midterm follow-up despite diagnostic and therapeutic improvements; its incidence is increasing and reaches 20–30% of all infective endocarditis episodes. In this review, changes in epidemiology, microbiology, diagnosis and therapy that have evolved in the past few years are analyzed. Staphylococci (both Staphylococcus aureus and coagulase-negative Staphylococcus) have emerged as the most common cause of PVE and are associated with a severe prognosis. Moreover, diagnosis may often be difficult because of its complications and extracardiac manifestations; thus, a comprehensive assessment of the clinical, echocardiographic and laboratory data must be performed. Early PVE, comorbidity, severe heart failure and new prosthetic dehiscence are predictors of mortality. Therapy is not indicated by evidence-based recommendations but mostly on identification of the high-risk conditions. A PVE is a common indication for surgery, whereas medical treatment alone may be achieved in a few instances. Systematic prophylaxis should be used to prevent this severe complication of cardiac valve replacement. © 2010 Italian Federation of Cardiology. All rights reserved.