Infective endocarditis (IE) is a severe condition, with elevated in-hospital mortality and morbidity due to complications such as acute heart failure and embolic events, the latter largely involving the central nervous system [1]. After the publication of several large clinical studies [2–5], indications to cardiac surgery have changed remarkably over the last 10 years. At present, surgery is highly recommended (class I) in the presence of severe valvular damage, uncontrolled infection, or persistent vegetations >10 mm associated with one or more embolic events despite appropriate antibiotic therapy [6].
