Surgery is typically indicated in Patients with heart failure (particularly those with prosthetic, aortic, or native mitral valve endocarditis and those with pulmonary edema or cardiogenic shock) Patients with uncontrolled infection (those with persistent infection, infection with fungal or resistant organisms, recurrent prosthetic valve endocarditis, or endocarditis complicated by heart block, abscess, aneurysm, fistula, or enlarging vegetation) Patients at risk for embolism (particularly those with prosthetic, aortic or mitral native valve endocarditis, and large vegetations [defined in the United States as > 10 mm] or those with recurrent emboli).