Background: Recently developed strategies (valve repair, 
homograft implantation) may improve clinical outcome in surgical 
treatment of infective endocarditis. Careful TEE examination may 
allow to choice the proper surgical treatment in relation to observed 
anatomic abnormalities. Aim of present investigation was to 
analyse survival and recurrent endocarditis in patients in whom 
surgical strategy was planned by TEE examination.  
Methods: 80 consecutive patients with active infective endocarditis 
(52 males, 28 females, mean age 59.2 years) were investigated. All 
patients underwent TEE examination within 24 hours from hospital 
admission. 78 patients underwent surgery, 2 patients died before 
intervention.  
Results: Aortic was involved more frequently than mitral valve (38 
vs. 28 patients). In 10 both valves were involved. Four had 
tricuspid endocarditis. 24 underwent aortic valve replacement, 12 
aortic homograft implant, 2 aortic valve repair, 18 mitral valve 
replacement and 13 mitral valve repair. Five underwent mitral and 
aortic replacement. In tricuspid endocarditis valve was repaired in 2 
and replaced in 2. Only in one patient surgical exploration induced 
to change planned strategy. Hospital mortality was 10.2%. 3 
discharged patients died at 18 months follow-up. Endocarditis 
recurred in 4, 2 being S. Aureus prosthetic tricuspid endocarditis in 
drug addicts. All patients who underwent valve repair or homograft 
implant were alive and free of recurrence.  
Conclusion: Our results suggest that TEE guided surgical 
treatment of active infective endocarditis is associated with a low 
mortality and recurrence rate.