ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026
Preoperative coronary evaluation in valve surgery for infective endocarditis: findings from a multicenter retrospective study.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeInternational guidelines recommend invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) before surgery for infective endocarditis (IE). Given the low level of evidence for this recommendation, we aimed to assess the impact of coronary evaluation in this context.
methodsThis multicenter retrospective study included adult patients diagnosed with IE who underwent cardiac surgery, and whose coronary status was considered unknown at the time of IE diagnosis. Patients were divided in two groups: those who underwent a coronary evaluation (C group) and those who did not (NC group). The primary endpoint was to determine the prevalence of coronary evaluation during the preoperative workup for IE. Secondary endpoints included the safety of coronary evaluation, the prevalence of coronary revascularization, and the one-year post-operative prognosis.
results323 patients were included, with 43% in the NC group and 57% in the C group (ICA for 149 patients, CCTA for 35 patients). Coronary evaluation found no lesion, non-significant coronary artery disease (CAD), and significant CAD in 51.1%, 28.8%, and 20.1% of cases, respectively. Thirteen patients underwent coronary artery bypass graft during the IE surgery. Tolerability of ICA was excellent: no embolic events and no additional renal toxicity.
conclusionWhile coronary evaluation was recommended for almost all patients, it was only performed in just over half of the cases. Preoperative coronary assessment remains useful and safe, but should probably not delay urgent valvular surgery.
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