Heart failure (HF) is the most common complication of acute infective endocarditis (IE), occurring in 42–60% of patients [1–2]. HF is mainly related to aortic or mitral regurgitation, but associated sepsis-induced myocardial dysfunction can occur [3]. HF is a major indication for urgent/emergent cardiac surgery (UECS) [1] and strongly influences its timing. In patients with severe HF (NYHA III-IV, persisting pulmonary edema or cardiogenic shock) despite medical therapy, UECS should be performed [1].
