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Comprehensive Care Approach to Drug-Related Tricuspid Valve Endocarditis Using Percutaneous Vegectomy
Matthew McAuliffe1, Armando Paez2, Siavash Saadat3
1Division of Internal Medicine, University of Massachusetts Chan School of Medicine-Baystate, Springfield, Massachusetts, USA.
Background:
Tricuspid valve endocarditis is more prevalent in the population of patients who inject intravenous drugs. The comorbidity of active addiction significantly complicates treatment in this population and multidisciplinary management is required.
Case Summary:
A young man with a history of active injection drug use presented with isolated tricuspid valve endocarditis. The patient was deemed a poor surgical candidate because of active addiction. The patient underwent percutaneous vegectomy with successful aspiration of vegetation.
Discussion:
Multidisciplinary management played a critical role in the patient's recovery and eventual surgical intervention. Although tricuspid valve endocarditis is common, management of active addiction complicates management. Currently no guidelines exist for management of infective endocarditis in intravenous drug use.
Take-Home Messages:
Percutaneous vegectomy can be a useful tool to reduce morbidity and mortality in patients with drug use-related infective endocarditis. Multidisciplinary management is critical for success in these high-risk patients.
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