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Management of patients with infective endocarditis by a multidisciplinary team approach: an operative protocol

Chirillo, Fabio; Scotton, Piergiorgio; Rocco, Francesco; Rigoli, Roberto; Polesel, Elvio; Olivari, Zoran

Journal of Cardiovascular Medicine: September 2013 - Volume 14 - Issue 9 - p 659–668
doi: 10.2459/JCM.0b013e32835ec585
Original articles: Infective endocarditis

Even in the modern era of advanced diagnostic imaging, improved antibiotic therapy and potentially curative surgery, infective endocarditis remains a serious disease with high rates of morbidity and mortality. Reasons for such a persistently poor outcome may be represented by the changing epidemiology and microbiology, with new groups of patients at risk and new and more aggressive microorganisms. However, the inadequate use of both diagnostic (blood cultures and echocardiography) and therapeutic (antibiotics and surgery) means can influence the generally delayed diagnosis and poor prognosis seen in patients with infective endocarditis. We tried to identify the critical points in the management of patients with infective endocarditis and to elaborate a formal multidisciplinary approach based on the strict collaboration of specialists in infectious diseases, microbiology, cardiology and cardiac surgery. We hypothesized that this approach could increase the adherence to the published guidelines, and could represent a means to improve the outcome of patients with infective endocarditis.

aDepartment of Cardiology

bDepartment of Infectious Diseases

cDepartment of Cardiovascular Surgery

dInstitute of Microbiology, Ca’ Foncello Hospital, Treviso, Italy

Correspondence to Fabio Chirillo, MD, Department of Cardiology, Ca’ Foncello Hospital, Piazzale Ospedale 1, Treviso 31100, Italy Tel: +39 0 422 322767; fax: +39 0 422 322662; e-mail:;

Received 24 April, 2012

Revised 15 August, 2012

Accepted 5 January, 2013

© 2013 Italian Federation of Cardiology. All rights reserved.