Tricuspid valve endocarditis in the era of the opioid epidemic

Wallen, Tyler; Szeto, Wilson Y.; Williams, Matthew Leighton; Atluri, Pavan; Arnaoutakis, George J.; Fults, Marci; Sultan, Ibrahim; Desai, Nimesh D.; Acker, Michael A.; Vallabhajosyula, Prashanth

doi:10.1111/jocs.13600

Cited by 18 publications

(16 citation statements)

References 13 publications

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“…20,36,45,46,47,48 These studies were limited by the small sample sizes of PWID and markedly different ages and comorbidities 20,49 of the 2 populations, which limits the conclusions that could be drawn. Notably, it has also been shown that PWID selected for surgery were more urgent cases (taken to the operating room within 24 hours) and more likely to have active infection, with the causative agent being S aureus, 50 suggesting a more unstable population.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Factors Associated With Mortality in First-Episode Infective Endocarditis Among Persons Who Inject Drugs

et al. 2018

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Key Points Question In first-episode infective endocarditis in persons who inject drugs, what are the clinical differences between patients who receive surgery vs those who are medically treated, and which factors are associated with mortality? Findings In this case series of 370 first-episode cases of infective endocarditis, the main significant differences between persons who inject drugs who received surgery and those who did not were the site of infection and cardiac complications. Decreased mortality was associated with surgery and referral to addiction treatment services, while higher mortality was associated with left-sided and bilateral infections. Meaning In selected persons who inject drugs with first-episode endocarditis, surgical management and referral to addiction treatment were associated with reduced mortality.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Factors Associated With Mortality in First-Episode Infective Endocarditis Among Persons Who Inject Drugs

et al. 2018

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“…All infected tissue in and around the heart should be debrided extensively and be removed in its entirety. The aggressiveness of this approach ensures that the reinfection rate is minimized . Once all infected tissue is removed, the mediastinum is copiously irrigated with saline.…”

Section: Managementmentioning

confidence: 99%

Management of thoracic aortic graft infections

et al. 2018

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“…Though small in number, results have been promising for tricuspid valve infective endocarditis. Surgeons may be hesitant to replace the TV in the patients with active or recurrent IV drug abuse or multiple co‐morbidities . VAT may debulk these vegetations and allow for medical therapy without the need for surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

The role of percutaneous vacuum-assisted thrombectomy for intracardiac and intravascular pathology

et al. 2018

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Vacuum-assisted thrombectomy (VAT) is a mechanical suction device that can be deployed to aspirate thrombi in the heart and vascular system. Successful percutaneous aspiration of iliocaval, right heart, and pulmonary arterial thrombi have been reported, in addition to the debulking of intravascular and intracardiac masses and vegetations. VAT is indicated for patients who are poor surgical candidates and/or have a contraindication to thrombolysis. This review discusses the mechanism, current results, potential clinical indications, and limitations of VAT for iliocaval and intracardiac mass removal.

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Tricuspid valve endocarditis in the era of the opioid epidemic

Abstract: In a span of 5 years, our institution has noted a fivefold increase in surgical volume for tricuspid endocarditis, most likely related to the impact of the opioid epidemic.

Cited by 18 publications

References 13 publications

Clinical Characteristics and Factors Associated With Mortality in First-Episode Infective Endocarditis Among Persons Who Inject Drugs

Clinical Characteristics and Factors Associated With Mortality in First-Episode Infective Endocarditis Among Persons Who Inject Drugs

Management of thoracic aortic graft infections

The role of percutaneous vacuum-assisted thrombectomy for intracardiac and intravascular pathology

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