In cases of persistent embolisation, surgery may be considered particularly if it can achieve other goals like valve repair or abscess drainage. If there is an indication for surgery, it should not be delayed as this only increases risk of further embolisation and complications. However if patients have had neurological complications surgery must be delayed for 2-3 weeks after a non-haemorrhagic stroke and 4 weeks after a haemorrhagic one as surgery increases risk for further sequelae.
Splenic abscesses may require guided percutaneous drainage or splenectomy.
Persistent mycotic aneurysms, especially when they involve cerebral vessels may also require surgical intervention.