BACKGROUND AND AIM OF THE STUDY: A treatment dilemma arises when @entity884 is complicated by @entity999 . @entity1779 may arise following suppression of coagulation during extracorporeal circulation. Extensive @entity340 is regarded as an indicator for urgent surgery. The study aim was to determine the relative risk of @entity1031 , and to analyze the prognostic influence of different treatment strategies following onset of these complications, in particular, secondary cerebral hemorrhagic events after urgent surgery. METHODS: Between 1978 and 1993, @entity884 was diagnosed in 288 consecutive @entity1 . @entity1 treated before 1982 (6.9%) were analyzed retrospectively. The remaining @entity1 (93.1%) were followed prospectively (mean 4.3+/-1.7 years). RESULTS: In 50 @entity1 (17.4%), the clinical course was complicated by one @entity887 , and in 58 @entity1 (20.2%) by recurrent @entity887 . In total, 71% of all @entity887 were cerebral events. The operated @entity1 were categorized with regard to the time between recurrent @entity1031 and cardiac surgery (<72 h, 3-8 days, and >8 days). The prognosis for @entity1 operated within 72 h was significantly more favorable (p <0.0001) than for those treated medically. @entity1 undergoing cardiac surgery more than eight days after @entity64 , and those treated conservatively, had poor prognoses. CONCLUSION: When @entity884 is complicated by @entity64 , it is recommended that cardiac surgery be performed within 72 h of the @entity999 , when the risk of @entity1779 appears to be low. Cranial computed tomography is obligatory immediately before surgery in order to identify @entity1 with early reperfusion @entity548 due to spontaneous fragmentation of the @entity715 . In these @entity1 , cardiac surgery must be postponed because of the high risk of severe @entity1779 during extensive perioperative anticoagulation, and is only justified in the case of an otherwise unfavorable prognosis.

@entity64 is not a contraindication for urgent valve replacement in XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhages'] @entity999 :: ('MESH:D020766', 'Disease') :: ['cerebral embolism'] @entity887 :: ('MESH:D004617', 'Disease') :: ['embolisms', 'embolism'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolic events', 'thromboembolic complications'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombus'] @entity340 :: ('MESH:D006349', 'Disease') :: ['valvular vegetation'] @entity1779 :: ('MESH:D002543', 'Disease') :: ['secondary cerebral hemorrhage', 'cerebral bleeding', 'Secondary cerebral hemorrhagic complications'] @entity884 :: ('MESH:D004696', 'Disease') :: ['endocarditis']
@entity884 :: (MESH:D004696,Disease) :: ['acute infective endocarditis']
