Tricuspid valve endocarditis in the era of the opioid epidemic

We reviewed our institutional experience with tricuspid valve endocarditis to understand the impact of the opioid epidemic on the incidence of right heart endocarditis.

We retrospectively reviewed all cases of tricuspid endocarditis managed surgically from January of 2011 to May of 2017. There were no exclusion criteria.

A total of 126 patients were identified. There were seven cases in 2011 and 36 in 2016. The average age of the patients decreased from 52.85 ± 19.6 years in 2011 to 39.2 ± 12.9 in 2017. Caucasians comprised 71% of the patients in 2011 and 75% in 2016. Tricuspid valve replacement was performed in 74 patients (58.73%) and repair was performed in 52 (41.27%). Thirty-day mortality was 11.11%. Reoperation, stroke and renal failure requiring dialysis during the index hospitalization were 5.6%, 0.8%, and 8%, respectively. Staphylococcus aureus, found in 43% of cases, was the most common isolate throughout the study period. Streptococcus was the second most common causative agent.

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.