Tricuspid Valve Excision Complicated by Postoperative Gerbode Defect Following Recurrent Infective Endocarditis: A Case Report

2020 ◽  
pp. 108925322095226
Author(s):  
Jasdeep S. Dhaliwal ◽  
Michael J. Wadle ◽  
Rajasekhar Malyala ◽  
Sanjay Dwarakanath ◽  
Kevin W. Hatton
Keyword(s):  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Surgical Intervention ◽  
Critically Ill Patient ◽  
Opioid Epidemic ◽  
Intravenous Drug Use ◽  
Recurrent Infections ◽  
Number Of Patients ◽  
Gerbode Defect ◽  
Tricuspid Valve Endocarditis

Tricuspid valve infective endocarditis is an increasingly common sequela of the opioid epidemic. While often managed medically, certain subsets of patients will require surgical intervention, including repair, replacement, and possibly even excision. Historically, simple valvectomy was performed in instances of recidivism and reinfection; however, reoperation and replacement has become the preferred treatment in the current era. Given the increasing incidence of intravenous drug use and the increase in the number of patients presenting with recurrent infections, simple valvectomy has regained favor in recent years. In this article, we present the management of a critically ill patient with recurrent tricuspid valve endocarditis who underwent tricuspid valvectomy that was complicated by a left ventricle to right atrium fistula and discuss some of the most important perioperative issues and complications for patients who undergo tricuspid valvectomy.

scholarly journals Pediatric Tricuspid Valve Infective Endocarditis- Insite into a challenging management

2020 ◽  
Author(s):  
Amitabh Satsangi ◽  
DHARAMRAJ SINGH
Keyword(s):  
Infective Endocarditis ◽  
Ventricular Septal Defect ◽  
Tricuspid Valve ◽  
Heart Block ◽  
Septal Defect ◽  
Surgical Intervention ◽  
Complete Heart Block ◽  
Heart Defects ◽  
Diagnostic Methods ◽  
Tricuspid Valve Endocarditis

:Pediatric tricuspid vavle endocarditis is an uncommon entity which is now becoming prevalent oweing to improved diagnostic methods and increase number of cardiac surgeries.Paediatric right sided infective endocarditis are mostly secondary to structural heart defects or indwelling venous catheters .We present a case of paeditric tricuspid valve endocarditis presenting with complete heart block,septic arthritis, pulmonary abcess with no structural heart defect diagnosted preoperatively.Intra-operatively a ventricular septal defect was diagnosed and managed .We present the difficult management of the case by medical and surgical intervention and management of secondary fungal infective endocarditis with repeated successful surgical intervention . We also emphasize on lack of established guidelines for management of right -sided infective endocarditis.

Tricuspid valve endocarditis following over-the-counter intravenous injection of skin-whitening products

2021 ◽  
pp. 201010582110666
Author(s):  
Huzairi Sani ◽  
Nada S Zulkufli ◽  
Yi L Gan ◽  
Ainur F Nadzir ◽  
Sazzli Kasim
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Intravenous Injection ◽  
Tricuspid Valve ◽  
Clinical Implications ◽  
Intravenous Drug Use ◽  
Over The Counter ◽  
Skin Whitening ◽  
Central Catheters ◽  
Tricuspid Valve Endocarditis

Intravenous drug use, central catheters and intracardiac devices are known predispositions to right-sided infective endocarditis (IE). We report a case of tricuspid IE caused by Acinetobacter seifertii and Enterobacter bugandensis as a result of intravenous use of skin-whitening products bought online. Clinical implications and pharmaceutical regulations are briefly discussed.

Gerbode Defect with Staphylococcus lugdunensis Native Tricuspid Valve Infective Endocarditis

2012 ◽  
Vol 27 (3) ◽  
pp. 316-320 ◽  
Author(s):  
Robert J. Carpenter ◽  
Gregory D. Price ◽  
Gilbert E. Boswell ◽  
Keshav R. Nayak ◽  
Alfredo R. Ramirez
Keyword(s):  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Staphylococcus Lugdunensis ◽  
Gerbode Defect

Tricuspid valve endocarditis in the era of the opioid epidemic

2018 ◽  
Vol 33 (5) ◽  
pp. 260-264 ◽  
Author(s):  
Tyler J. Wallen ◽  
Wilson Szeto ◽  
Matthew Williams ◽  
Pavan Atluri ◽  
George Arnaoutakis ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Opioid Epidemic ◽  
Tricuspid Valve Endocarditis

The Lived Experience of Nurses Caring for Patients Diagnosed With Intravenous Drug Use–Associated Infective Endocarditis in Appalachia: A Phenomenological Study

2021 ◽  
pp. 107839032110377
Author(s):  
Kendrea L. Todt ◽  
Sandra P. Thomas
Keyword(s):  
Substance Use ◽  
Infective Endocarditis ◽  
Drug Use ◽  
Substance Use Disorder ◽  
Phenomenological Study ◽  
Care Delivery ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Central Theme ◽  
Number Of Patients

BACKGROUND: The number of patients admitted with infective endocarditis (IE) from intravenous drug use (IVDU) in Appalachia is increasing, a direct downstream effect of the opioid crisis. Extant literature highlights the pejorative attitudes health care workers have toward patients with substance use disorder, with nurses among the most punitive. Rather than describe attitudes, the purpose of this study was to describe the lived experiences of nurses caring for patients diagnosed with IE from IVDU in Appalachia. OBJECTIVE: To describe an unexplored phenomenon in Appalachia to inform nursing practice, nursing education, and health policy. METHOD: Qualitative phenomenological study using the University of Tennessee method based on the tenets of Maurice Merleau-Ponty. Nine nurses (ages 29-53 years) recruited using purposive and snowball sampling participated in unstructured phenomenological interviews. RESULTS: The essential meaning or central theme of the nurse experience working with these patients was a sense of hopelessness/hope, with four interrelated themes derived from the central theme: (1) guarding/escaping, (2) responsibility and revulsion, (3) apathy/empathy, and (4) grief and sorrow/cold and unemotional. Universally, nurses perceived caring for this population as futile, feeling a sense of powerlessness to change the outcome. CONCLUSIONS: These care experiences frustrated nurses, who described being physically and emotionally drained. To improve care delivery and improve patient outcomes, emphasis must be placed on nurse addiction education and standardizing nurse to patient with substance use disorder ratios to decrease work-related stress on nurses.

scholarly journals Comparison of Valveplasty and Replacement for Surgical Treatment of Infective Tricuspid Valve Endocarditis

2021 ◽  
Author(s):  
Xie Linfeng ◽  
Chen Xiaodong ◽  
He Jian ◽  
Lin Sixian ◽  
Chen Xingfeng ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Drug Users ◽  
Clinical Effect ◽  
Clinical Results ◽  
Reoperation Rate ◽  
Red Blood Cell Transfusion ◽  
Significant Difference ◽  
Tricuspid Valve Endocarditis

Abstract Background In recent years, due to the increase in intravenous drug injection and intracardiac and vascular interventional treatments among drug users, infective endocarditis involving the right heart of the tricuspid valve has gradually increased.At present, there is no systematic report on surgical treatment of tricuspid infective endocarditis. This paper summarizes the experience of surgical treatment of 56 patients with tricuspid infective endocarditis in our hospital and analyzes its clinical effect. Methods From January 2006 to August 2019, 56 cases of tricuspid infective endocarditis treated by tricuspid valve surgery in our hospital were analyzed retrospectively.including 23 cases of tricuspid valvuloplasty (TVP) and 33 cases of tricuspid valve replacement (TVR). All patients were complicated with tricuspid valve vegetations or moderate and severe tricuspid regurgitation and had surgical indications.The perioperative data were collected and followed up for 6 months to 14 years to summarize and analyze the clinical effect of surgical treatment of tricuspid infective endocarditis. Results Compared with TVR group, the CPB time (79.68 ± 19.02min VS 107.39 ± 25.64min, P < 0.01), ACC time (50.29 ± 16.14min VS 65.52 ± 20.62min, P < 0.01), postoperative mechanical ventilation time (18.65 ± 8.18h VS 44.85 ± 57.68h, P < 0.01) and ICU stay time (38.13 ± 21.80h VS 102.64 ± 142.11h, P = 0.015) in TVP group were shorter. The perioperative red blood cell transfusion (4.87 ± 3.81U VS 7.55 ± 5.42U, P < 0.01) and the incidence of postoperative complications (8.7% VS 33.3%, P < 0.01) were lower.Perioperative death occurred in 1 case in the TVR group, and there was no perioperative death in the TVP group, There was no significant difference between the two groups(3.03% VS 0, P = 0.855). A total of 52 cases were followed up for an average of (5.50 ± 3.79) years.The postoperative 3-year, 5-year and 7-year survival rate were 100%,100%,91.7% in TVP group and 95.2%, 93.8% and 87.5%.The 5-year and 10-year reoperation rate were 0%, 0% in TVP group and 6.7%, 20% in TVR group. Conclusion Surgical treatment of severe tricuspid valve endocarditis has achieved good mid-term clinical results, and the rate of avoiding reoperation is better in TVP group than in TVR group.

scholarly journals Isolated Native Tricuspid Valve Endocarditis in a Nonintravenous Drug User

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Habtewold Shibru ◽  
Ermias shenkutie Greffie ◽  
Zenahbezu Abay ◽  
Oumer Abdu Muhie
Keyword(s):  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Drug Users ◽  
High Morbidity ◽  
Central Venous ◽  
Cardiac Device ◽  
Rural Ethiopia ◽  
Cardiac Devices ◽  
Underlying Risk ◽  
Tricuspid Valve Endocarditis

Infective endocarditis (IE) is a disease characterized by high morbidity and mortality. IE was first described in the mid-16th century. Right-sided infective endocarditis (RSIE) represents 5% to 10% of all IE episodes in adults. RSIE can be divided into three groups according to the underlying risk factors: intravenous drug users (IDUs), cardiac device carriers, and the “three noes” group (no left-sided IE, no IDUs, and no cardiac devices). Tricuspid valve endocarditis in nonintravenous drug users can occur in a variety of conditions including congenital heart disease, intracardiac devices, central venous catheters, and immunologically debilitated patients. Due to the rareness of isolated native nonrheumatic tricuspid valve endocarditis, here, we like to present an 18-year-old male from rural Ethiopia with the diagnosis of isolated native tricuspid valve endocarditis that was treated and cured.

Abstract P658: Epidemiology and Stroke Complications of IVDU-Associated Endocarditis in the Heart of the Opioid Epidemic

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
nguyen hoang ◽  
Ciaran Powers ◽  
Shahid M Nimjee ◽  
Patrick Youssef ◽  
Varun Shah
Keyword(s):  
Drug Abuse ◽  
Infective Endocarditis ◽  
Intracranial Hemorrhage ◽  
Clinical Care ◽  
The United States ◽  
Intravenous Drug ◽  
Opioid Epidemic ◽  
Number Of Patients ◽  
History Of ◽  
Brain Abscesses

Introduction: The United States is experiencing a rapidly increasing rate of opioid drug abuse. Intravenous drug use related endocarditis and resultant septic embolic stroke, intracranial hemorrhage and infectious intracranial aneurysm (IIAs) cause significant morbidity and mortality and have a significant impact on cost and clinical care. Methods: We conducted a retrospective cohort study involving patients treated for infective endocarditis (IE) at a single institution over a 54-month period between 1/1/2014 and 07/01/2018. Concomitant intravenous drug abuse and infective endocarditis was analyzed to identify and demographics, risk factors, and attributed costs. Results: A total of 351 patients met inclusion criteria with 170 patients (48%) having history of IVDU-associated endocarditis. From 2014 to 2018, there was a 630% increased incidence of patients with IVDU-associated endocarditis. Compared to endocarditis of other etiologies, a significant number of patients with IVDU-associated endocarditis were homeless (5.9% v 1.1%, p=0.014), uninsured (10.0% v 2.8%, p=0.005), and unemployed (75.9% v 31.7%, p=0.0001). IVDU was associated with an increased prevalence of overall intracranial hemorrhage (25.9% v 13.9%, p=0.005), including intraparenchymal hemorrhage (12.4% v 5.1%, p=0.012), subarachnoid hemorrhage (17.6 v 4.4%, p=0.0001), and cerebral microbleeds (14.1% v 7.2%, p=0.022). IVDU was also associated with an increased prevalence of IIAs (10.6% v 1.8%, p=0.0001) and brain abscesses (4.7% v 1.1%, p=0.025). Conclusions: The opioid epidemic has increased the incidence of infective endocarditis and resultant neurovascular complications. IVDU-associated endocarditis is associated with increased hemorrhagic stroke and increase healthcare utilization and costs.

scholarly journals Infective Endocarditis Caused by Neisseria elongata on a Native Tricuspid Valve and Confirmed by DNA Sequencing

2014 ◽  
Vol 41 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Yeon Pyo Yoo ◽  
Ki-Woon Kang ◽  
Hyeon Soo Yoon ◽  
Seungmin Yoo ◽  
Myung-Shin Lee
Keyword(s):  
Infective Endocarditis ◽  
Antibiotic Therapy ◽  
Dna Sequencing ◽  
Tricuspid Valve ◽  
Unusual Case ◽  
Blood Cultures ◽  
Gram Negative ◽  
Dental Procedures ◽  
Oral Bacterium ◽  
Gerbode Defect

Neisseria elongata, a common oral bacterium, has been recognized as a cause of infections such as infective endocarditis, septicemia, and osteomyelitis. Neisseria-induced infective endocarditis, although infrequently reported, typically arises after dental procedures. Without antibiotic therapy, its complications can be severe. We report the case of a 27-year-old man who presented with fever, severe dyspnea, and a leg abscess from cellulitis. An echocardiogram showed a vegetation-like echogenic structure on the septal leaflet of the patient's native tricuspid valve, and an insignificant Gerbode defect. Three blood cultures grew gram-negative, antibiotic-susceptible coccobacilli that were confirmed to be N. elongata. Subsequent DNA sequencing conclusively isolated N. elongata subsp nitroreducens as the organism responsible for the infective endocarditis. The patient recovered after 21 days of antibiotic therapy. In addition to the patient's unusual case, we discuss the nature and isolation of N. elongata and its subspecies.

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