Infective endocarditis (IE) is a life-threatening condition leading to progressive valvular destruction, hemodynamic instability, and increased mortality. Timely surgical intervention is often required when antibiotic therapy fails to halt infective pathology. This multicenter retrospective study evaluates surgical outcomes in 214 patients undergoing valve repair or replacement due to IE-induced structural damage between January 2022 and June 2024. Clinical endpoints included postoperative mortality, valve function at 6 months, recurrent infection, neurological complications, and length of hospital stay. Results revealed an overall 30-day mortality of 9.3%, lower in valve repair (6.8%) compared to replacement (12.2%). Recurrent IE occurred in 5.6% of cases, and mechanical prostheses showed higher thromboembolic complications than bioprosthetic valves. Findings suggest early surgical intervention combined with targeted antimicrobial therapy significantly improves survival and functional outcomes.