The indications for valve replacement in patients with endocarditis are:

1. congestive heart failure from valvular regurgitation;
2. failure of antibiotic therapy to successfully suppress the infection or infection with difficult-to-treat organisms (fungal, Pseudomonas, Brucella, drug-resistant organisms);
3. valvular annular abscess;
4. peripheral embolism of vegetation; and
5. size of vegetation > 1.0 cm.