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Eric V. Granowitz, MD; David L. Longworth, MD

JAMA. 2003;289:1991-1993.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Before the advent of antibiotics, infective endocarditis was almost always fatal. With the introduction of penicillin in 1941, endocarditis became a treatable disease. However, many patients still died, predominantly of congestive heart failure resulting from valve destruction.¹

In 1960, Kay et al² successfully performed tricuspid valve debridement and closure of a ventricular septal defect in a patient with active Candida endocarditis. For patients with endocarditis, cardiac valve replacement surgery was initially performed to replace damaged valves only after the successful eradication of infection. In 1965, Wallace et al³ described a patient with active endocarditis who failed to respond to antibiotics alone but was cured by the combination of valve replacement and antibiotics.

During the next 2 decades, reports from observational studies argued in favor of the effectiveness of valve replacement in patients with active endocarditis complicated by congestive heart failure or uncontrolled . . . [Full Text of this Article]

Author Affiliations: Department of Medicine, Baystate Medical Center and Tufts University School of Medicine, Springfield, Mass.

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