Ragnarsson S, Salto‐Alejandre S, Ström A, et al. - Relative to younger patients with infective endocarditis, elderly patients less frequently receive surgery. Findings revealed lower mortality in correlation with undergoing surgery irrespective of age. In matched elderly patients, patients who did not undergo surgery had higher long‐term mortality, indicating that surgery is underused in elderly patients.

• A total of 2,186 patients with left‐sided infective endocarditis recorded in the SRIE (Swedish Registry of Infective Endocarditis) were included in this nationwide retrospective study.

• Among these patients, 864 were aged < 65 years, 806 were 65 to 79 years, and 516 were ≥ 80 years.

• With increasing age, there was a reduction in the rate of surgery, from 46% in the < 65 group to 6% in the ≥ 80 group.

• In propensity‐matched groups, a significantly lower mortality rate was recorded between the ages of 55 and 82 years in patients who underwent surgery vs those who did not.

• In addition, better long‐term survival was observed in correlation with undergoing surgery in matched patients who were ≥ 75 years.