5 patients with primary infective endocarditis developed acute cardiac failure because of aortic valve insufficiency. 2 patients were in the active and 3 patients in the inactive stage of infective endocarditis. In 4 patients an aortic and in 1 patient an aortic and mitral valve replacement was performed. The early mortality rate (death within 30 days of operation) was 20 per cent. Once congestive heart failure starts during the course of active endocarditis surgery should be undertaken at an early date.
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