• Carolyn Weber, Christopher Hohmann, Oliver Lindner, Thorsten Wahlers, and Norma Jung.
• Department of Cardiothoracic Surgery, Heart Center, University Hospital Cologne; Department III for Internal Medicine - General and Interventional Cardiology, Electrophysiology, Angiology, Pneumology and Intensive Care Medicine, University Hospital Cologne; Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine-Westphalia, University Hospital Ruhr-University Bochum, Bad Oeynhausen-Universität Bochum; Department I of Internal Medicine - Oncology, Hematology, Division of Infectious Diseases, Clinical Immunology, Hemostaseology and internal Intensive Care Medicine, University Hospital Cologne.
• Dtsch Arztebl Int. 2023 Oct 13; 120 (41): 692702692-702.

BackgroundIn Germany, a total of 38 547 heart valve procedures were performed in 2022. With a growing number of patients undergoing the surgical and interventional implantation of heart valves, the incidence of prosthetic endocarditis is also rising.MethodsWe summarize the current state of the prophylaxis, diagnosis, and treatment of prosthetic endocarditis in a selective review of the literature.ResultsProsthetic endocarditis accounts for 10-30% of all cases of endocarditis. As its echocardiographic and microbiologic findings are often less specific than those of native endocarditis, its diagnosis now increasingly relies on alternative imaging modalities such as F-18-FDG PET-CT. Anti-infective and surgical treatment are made more difficult by biofilm formation on the prosthetic valve and the frequent formation of perivalvular abscesses.ConclusionIncreased awareness of this clinical entity in the outpatient setting will promote the earlier initiation of appropriate diagnostic studies. Proper diagnostic evaluation is an essential prerequisite for the early detection and timely treatment of prosthetic endocarditis, with the goal of preventing progressive destruction and thus improving the outcome. Preventive and educative measures should be intensified, and certified, multidisciplinary endocarditis teams should be established. Antibiotic prophylaxis is now given much more restrictively than in earlier years; the risk of infection must be weighed against the potential development of both individual and collective resistance to antibiotic drugs.

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