Risk, diagnosis and management of prosthetic valve endocarditis: A review

Angelo Vlessis, Ali Khaki, Gary L. Grunkemeier, Hui Hua Li, Albert Starr

Research output: Contribution to journalArticle

67 Scopus citations


Prosthetic valve endocarditis (PVE) emerged approximately 37 years ago when the first human heart valve replacements were performed. PVE can be classified as 'early' or 'late' with the pathophysiology and etiologic organisms varying between the two subgroups. The incidence of PVE ranges up to 0.5% per patient-year for mechanical mitral valves and up to 1.0% per patient-year for other valves. The clinical presentation is similar to that of native valve endocarditis, with fever being the most prevalent sign. Diagnosis is based on a constellation of clinical signs and symptoms as well as echocardiographic evaluation of the valve and perivalvular tissues. An algorithm is set forth for diagnosis and management of patients with suspected PVE based on our personal experience and the published literature. Indications for surgery, the surgical approach and methods of PVE prophylaxis and prevention are discussed.

Original languageEnglish (US)
Pages (from-to)443-465
Number of pages23
JournalJournal of Heart Valve Disease
Issue number5
Publication statusPublished - Sep 1997


ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Vlessis, A., Khaki, A., Grunkemeier, G. L., Li, H. H., & Starr, A. (1997). Risk, diagnosis and management of prosthetic valve endocarditis: A review. Journal of Heart Valve Disease, 6(5), 443-465.