Indication Class 1. Early prosthetic valve endocarditis (first 2 months or less after surgery). I 2. Heart failure with prosthetic valve dysfunction. I 3. Fungal endocarditis. I 4. Staphylococcal endocarditis not responding to antibiotic therapy. I 5. Evidence of paravalvular leak, annular or aortic abscess, sinus or aortic true or false aneurysm, fistula formation, or new-onset conduction disturbances. I 6. Infection with gram-negative organisms or organisms with a poor response to antibiotics. I 7. Persistent bacteremia after a prolonged course (7 to 10 days) of appropriate antibiotic therapy without noncardiac causes for bacteremia. IIa 8. Recurrent peripheral embolus despite therapy. IIa 9. Vegetation of any size on or near the prosthesis. IIb

¹ Criteria exclude repaired mitral valves or aortic allograft or autograft valves. Endocarditis is defined by clinical criteria with or without laboratory verification.