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12.6.3.2. Surgery ..................................................................................... 4006 12.7. Infective endocarditis in congenital heart disease .................. 4007 12.8. Infective endocarditis in rheumatic heart disease .................. 4008 12.9. Infective endocarditis during pregnancy .................................... 4008 12.10. Infective endocarditis in immunocompromised patients . 4008 12.10.1. Solid organ transplant recipients ........................................ 4008 12.10.2. Patients with human immunodeficiency virus ............... 4008 12.10.3. Patients with neutropaenia ................................................... 4009 12.11. Antithrombotic and anticoagulant therapy in infective endocarditis ....................................................................................................... 4009 12.12. Non-bacterial thrombotic endocarditis .................................. 4009 12.13. Infective endocarditis and malignancy ...................................... 4010 13. Patient-centred care and shared decision-making in infective endocarditis ............................................................................................................. 4010 13.1. What is patient-centred care and shared decision-making and why is it important? ............................................................................... 4010 13.2. Patient-centred care and shared decision-making in infective endocarditis ....................................................................................................... 4010 14. Sex differences ............................................................................................... 4011 15. Key messages .................................................................................................. 4012 16. Gaps in evidence ............................................................................................ 4013 17. ‘What to do’ and ‘What not to do’ messages from the Guidelines ................................................................................................................. 4014 18. Supplementary data ...................................................................................... 4020 19. Data availability ............................................................................................... 4020 20. Author information ...................................................................................... 4020 21. Appendix ........................................................................................................... 4021 22. References ........................................................................................................ 4021

Tables of Recommendations Recommendation Table 1 — Recommendations for antibiotic prophylaxis in patients with cardiovascular diseases undergoing oro-dental procedures at increased risk for infective endocarditis 3961 Recommendation Table 2 — Recommendations for infective endocarditis prevention in high-risk patients ............................................ 3963 Recommendation Table 3 — Recommendations for infective endocarditis prevention in cardiac procedures ....................................... 3963 Recommendation Table 4 — Recommendations for the Endocarditis Team ................................................................................................ 3965 Recommendation Table 5 — Recommendations for the role of echocardiography in infective endocarditis ................................................ 3969 Recommendation Table 6 — Recommendations for the role of computed tomography, nuclear imaging, and magnetic resonance in infective endocarditis ........................................................................................... 3970 Recommendation Table 7 — Recommendations for antibiotic treatment of infective endocarditis due to oral streptococci and Streptococcus gallolyticus group ........................................................................ 3977 Recommendation Table 8 — Recommendations for antibiotic treatment of infective endocarditis due to Staphylococcus spp. ........ 3980 Recommendation Table 9 — Recommendations for antibiotic treatment of infective endocarditis due to Enterococcus spp. .................. 3982 Recommendation Table 10 — Recommendations for antibiotic regimens for initial empirical treatment of infective endocarditis (before pathogen identification) ..................................................................... 3985 Recommendation Table 11 — Recommendations for outpatient antibiotic treatment of infective endocarditis ........................................... 3987 Recommendation Table 12 — Recommendations for the main indications of surgery in infective endocarditis (native valve endocarditis and prosthetic valve endocarditis) ....................................... 3991 Recommendation Table 13 — Recommendations for the treatment of neurological complications of infective endocarditis ....................... 3992 Recommendation Table 14 — Recommendations for pacemaker implantation in patients with complete atrioventricular block and infective endocarditis ........................................................................................... 3993 Recommendation Table 15 — Recommendations for patients with musculoskeletal manifestations of infective endocarditis .................... 3994 Recommendation Table 16 — Recommendations for pre-operative coronary anatomy assessment in patients requiring surgery for infective endocarditis ........................................................................................... 3995 Recommendation Table 17 — Indications and timing of cardiac surgery after neurological complications in active infective endocarditis ............................................................................................................. 3997 Recommendation Table 18 — Recommendations for post-discharge follow-up ................................................................................... 3999 Recommendation Table 19 — Recommendations for prosthetic valve endocarditis .................................................................................................. 4000 Recommendation Table 20 — Recommendations for cardiovascular implanted electronic device-related infective endocarditis ................. 4004 Recommendation Table 21 — Recommendations for the surgical treatment of right-sided infective endocarditis ........................................ 4007 Recommendation Table 22 — Recommendations for the use of antithrombotic therapy in infective endocarditis .................................... 4009

List of tables Table 1 Classes of recommendations .......................................................... 3953 Table 2 Levels of evidence ................................................................................ 3953 Table 3 New recommendations .................................................................... 3955 Table 4 Revised recommendations ............................................................... 3957 Table 5 General prevention measures to be followed in patients at high and intermediate risk of infective endocarditis .............................. 3960 Table 6 Prophylactic antibiotic regime for high-risk dental procedures ............................................................................................................... 3961 Table 7 Members of the Endocarditis Team ............................................ 3963 Table 8 Cardiac and non-cardiac risk factors ........................................... 3965 Table 9 Investigation of rare causes of blood culture-negative infective endocarditis ........................................................................................... 3967 Table 10 Definitions of the 2023 European Society of Cardiology modified diagnostic criteria of infective endocarditis ............................. 3971 Table 11 Antibiotic treatment of blood culture-negative infective endocarditis ............................................................................................................. 3984 Table 12 Features favouring a non-mechanical valve substitute in the setting of surgery for acute infective endocarditis ................................. 3997 Table 13 Factors associated with an increased rate of relapse of infective endocarditis ........................................................................................... 3999 Table 14 ‘What to do’ and ‘What not to do’ .......................................... 4014 List of figures Figure 1 Management of patients with infective endocarditis ........... 3954 Figure 2 Education of high-risk patients to prevent infective endocarditis ............................................................................................................. 3962 Figure 3 Management of patients with infective endocarditis: positioning of the Endocarditis Team .......................................................... 3964

ESC Guidelines                                                                                                                                                                                          3951

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