Dear Colleagues,

Despite major advances in diagnosis and therapy, infective endocarditis (IE) continues to carry high mortality. Optimal management remains crucial for improving clinical outcomes. Departing from the conventional paradigm, IE may present with atypical features or arise in individuals without pre-existing cardiac disease. In such unexpected presentations, IE is often overlooked, leading to delayed diagnosis and complex management challenges. Concurrently, a new “at-risk” cohort has emerged from the increasing number of interventional procedures performed in elderly, frail patients with multiple comorbidities. This development further complicates both diagnostic evaluation and therapeutic decision-making. Because IE can occur as a complication of both cardiac and non-cardiac interventions, prompt recognition and timely initiation of therapy are essential to reduce adverse outcomes.

Beyond established emergency criteria (such as vegetation size, major complications, and acute heart failure), the optimal timing of intervention, the selection of surgical strategies, and the criteria for a conservative approach remain poorly standardized.

This Special Issue aims to refine contemporary treatment pathways by sharing clinical experience across diverse scenarios. We welcome Reviews, Original Researches, Systematic Reviews, Short Communications, Opinions addressing topics such as:

-Extra-cardiac complications of IE

-Management after first embolization

-IE and advanced kidney disease (including hemodialysis)

-Long-term oral therapy

-Fungal endocarditis

-Anticoagulation during IE

-Conservative management

-IE in cancer patients

-IE after cardiac and non-cardiac interventions

-IE in frail patients

-Surgical repair of post-IE valve lesions

-Applicability and timing of interventional cardiology

-Judicious omission of surgery

Giovanni La Canna
Guest Editor