Background: Surgery for active endocarditis is indicated in cases of congestive heart failure (CHF), persistent sepsis, systemic embolization and paravalvular involvement. Aim: To assess and report the long term. results of surgery in adult patients. Patients and methods. Retrospective review of clinical records and operative procedures of 32 patients aged 43 +/- 13 years (28 women) subjected to reparative surgery for complications of endocarditis between 1993 to 2005. Results. In 25% of cases, endocarditis presented as a prolonged sepsis syndrome and in 31% as a CHF or both. The causative bacteria was Gram (+) in 53% and blood cultures were negative in 47%. Preoperative echocardiography showed vegetations in 56% of cases. An annular abscess, aortic valve rupture and bicuspid valve, was observed in 13% of patients. Post operative mortality was due to persistent sepsis and multiorganic dysfunction in 16%. Mean long term follow up was 43 +/- 47.2 months. Actuarial survival was 78% at 146 months. Conclusion: Surgical management of active endocarditis provides a good symptomatic recovery, with an excellent long term. actuarial survival (Rev Med Chile 2008. 136: 31- 7).