Valve replacement for left-sided endocarditis in drug addicts.

Area of Science:

• Cardiology
• Infectious Diseases
• Cardiac Surgery

Background:

• Left-sided infective endocarditis is a serious condition, particularly in intravenous drug users.
• Staphylococcus aureus and Pseudomonas aeruginosa are common pathogens in this population.
• Surgical intervention is frequently required due to sepsis, heart failure, or emboli.

Purpose of the Study:

• To review the outcomes of surgical treatment for left-sided infective endocarditis in drug addicts.
• To identify risk factors and complications associated with this patient group.

Main Methods:

• Retrospective review of 18 drug addicts with left-sided infective endocarditis requiring surgery.
• Analysis of causative organisms, indications for surgery, complications, and mortality rates.

Main Results:

• Gram-positive bacteria (61%) and Gram-negative bacteria (39%, exclusively Pseudomonas aeruginosa) were identified.
• Indications for surgery included sepsis (61%), heart failure (78%), and systemic emboli (22%).
• Early mortality was 11%, with major complications in 79% of patients, leading to an overall 50% mortality within nine months.

Conclusions:

• Infective endocarditis in drug addicts is a highly lethal disease.
• Virulence of organisms, severe complications, and continued addiction contribute to poor surgical outcomes.
• This contrasts with previous reports suggesting acceptable surgical survival for valvular endocarditis.