Abstract:
Objective: Endocarditis is a severe, potentially fatal infection of cardiac valves or endocardium, characterized by high morbidity and complex management. This study aims to synthesize contemporary clinical, microbiological, and therapeutic data, highlighting strategies for early diagnosis, risk stratification, and precision-guided treatment.
Methods: A systematic review of international literature (2015–2025) was conducted, encompassing multicenter studies, ESC and ACC/AHA guidelines, and epidemiological analyses. The review focused on:
• Risk factors (valvular disease, intravenous drug use, prior cardiac surgery),
• Causative pathogens (Staphylococcus aureus, Enterococci, HACEK),
• Diagnostic modalities (blood cultures, transesophageal echocardiography, PET-CT, inflammatory biomarkers),
• Therapeutic strategies (targeted antibiotics, surgical intervention).
Results: Endocarditis incidence is increased in patients with predisposing cardiac or systemic conditions. Early diagnosis through integrated laboratory and imaging protocols reduces mortality by over 20%. Causative pathogens dictate individualized antimicrobial regimens, while surgical intervention is required in approximately 50% of cases with valvular destruction or hemodynamic compromise. Emerging strategies, including PET-CT guided monitoring, rapid molecular pathogen identification, and multidisciplinary care, optimize clinical outcomes. Precision-based therapy minimizes relapse and enhances long-term cardiac function. Biomarker-guided risk stratification allows identification of high-risk patients and informs timing of surgical intervention, reducing complication rates and improving survival.
Conclusions: Endocarditis remains a significant clinical challenge, demanding a multidisciplinary approach that combines advanced diagnostics, pathogen-directed therapy, and individualized surgical planning. Integration of early detection, risk stratification, and evidence-based therapeutic strategies substantially improves survival and functional recovery. Future directions in precision cardiology include molecular pathogen profiling, predictive analytics for complications, and tailored antibiotic-surgical protocols.
Biography:
Christos Simoglou MD, MSc, PhD completed his residency training in General Surgery at Komotini General Hospital, actively participating in and performing a large number of surgical procedures, with additional postgraduate training in the United States (Zuckerberg San Francisco General Hospital – Department of General Surgery & Trauma). He was fully involved in all clinical activities of the department and also provided coverage in the Intensive Care Unit (ICU).
Subsequently, within the framework of his specialist training for the acquisition of the Thoracic Surgery specialty, he focused exclusively on Cardiac and Thoracic Surgery at the University General Hospital of Evros, where he gained extensive experience in both emergency and elective cases. He assisted in a large number of procedures and also served as the primary surgeon in major open-heart and thoracic surgeries.
Concurrently, he participated in the on-call rota of the department and served as a key member of the Intensive Care Unit, where he acquired comprehensive expertise in the management of postoperative cardiac and thoracic surgery patients, including mechanical ventilation and the use of the intra-aortic balloon pump (IABP), gaining substantial experience in postoperative critical care monitoring.
He served as an Assistant Consultant (Grade B) in Cardiac Surgery at the University General Hospital of Heraklion, Crete, where he consistently participated in the on-call program of the Cardiac Surgery Department, in surgical procedures, and in the management of critically ill cardiothoracic patients in the ICU and Emergency Department. He also undertook on-call duties in the Thoracic Surgery Department, participated in thoracic surgical procedures, and covered the full spectrum of medical acts in the Cardiac Intensive Care Unit.
He later served as Head of the Cardiac Surgery Department and the Cardiothoracic Intensive Care Unit at Hippocratio General Hospital of Athens, practicing as a Cardiac Surgeon.
He further served as a Postgraduate Fellow in Cardiac Surgery at the Second Cardiac Surgery Department of Heart and Lung Transplantation and Mechanical Circulatory Support at the Onassis Cardiac Surgery Center, Athens.
Additionally, he served as an Assistant Thoracic Surgeon at the Korgialenio–Benakio General Hospital of Athens, Hellenic Red Cross. In the field of Thoracic Surgery, beyond conventional open and thoracoscopic procedures, he specializes in advanced techniques such as pectus excavatum repair, with continuous postgraduate training abroad in Europe (UK) and the United States, including the Thoracic Surgery Clinic at UW Medical Center – Montlake, Seattle, USA.
He has authored more than 100 medical articles, abstracts, and presentations published in Greek and international journals, and has participated in a large number of national and international medical scientific conferences, contributing to scientific publications and research projects in Europe and the United States.
