Left-sided endocarditis (LSE) represents a significant proportion of urgent cardiac surgeries.1 It requires expertise and capabilities for dealing with endocardial and myocardial damages involving all or portion of mitral valve, all or portion of the aortic valve, aortic root and the structures in their anatomical contiguity.2 Literature and guidelines on the management of LSE rely mainly on observational studies, given the challenges associated with the conduct of randomised trials in emergency settings. Endocarditis teams (ETs) are mandatory.3 The role of regular meetings among specialties is fundamental, particularly for frail or extremely sick patients. Decision-making should take into account not only the localisation and the extension of the infection, but also the patient preoperative status and his comorbidities. Previous cardiac surgery, and especially previous valve prosthesis, impact on the prognosis. The best timing is still a matter of debate not only according to the risks but also the feasibility of very early surgery for LSE. Various scores have been developed for preoperative estimates of the mortality associated with cardiac surgeries in different settings.4 5 The ENDOVAL score aims to help and guide the ET for an individualised decision-making process.4 Despite evidence suggests that early surgery may be associated with improved survival in patients with complicated LSE, it also incurred an increased risk of recurrence and postoperative valvular dysfunctions, according to …

中文翻译：

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在左侧感染性心内膜炎的任何情况下进行心脏手术？

左侧心内膜炎 (LSE) 在紧急心脏手术中占很大比例。1 它需要专业知识和能力来处理涉及全部或部分二尖瓣、全部或部分主动脉瓣、主动脉根部和结构的心内膜和心肌损伤2 关于 LSE 管理的文献和指南主要依赖于观察性研究，因为在紧急情况下进行随机试验会带来挑战。心内膜炎团队 (ET) 是强制性的。3 专家之间定期会议的作用至关重要，尤其是对于虚弱或重病患者。决策不仅要考虑感染的定位和扩展，还要考虑患者的术前状态和合并症。以前的心脏手术，尤其是既往人工瓣膜，影响预后。最佳时机仍然是一个有争议的问题，不仅取决于风险，还取决于 LSE 早期手术的可行性。已经开发了各种评分来评估不同情况下与心脏手术相关的死亡率。4 5 ENDOVAL 评分旨在帮助和指导 ET 进行个体化决策过程。4 尽管有证据表明早期手术可能与根据……提高了复杂 LSE 患者的生存率，同时也增加了复发和术后瓣膜功能障碍的风险。