Management of Isolated Native Tricuspid Valve Infective Endocarditis by a Multidisciplinary Program: A Single-Center Retrospective Cohort Study

Division

West Florida

Hospital

Medical Center of Trinity

Document Type

Manuscript

Publication Date

9-27-2024

Keywords

endocarditis, multidisciplinary teams, patients who use drugs, tricuspid valve disease

Disciplines

Cardiovascular Diseases | Internal Medicine | Medicine and Health Sciences

Abstract

BACKGROUND: Isolated native tricuspid valve infective endocarditis remains a challenging disease to treat given the large number of patients with substance use disorder. There is limited data on the optimal treatment strategy and the impact of a multidisciplinary endocarditis program on outcomes for this population.

OBJECTIVES: To assess the clinical outcomes associated with management of native tricuspid valve infective endocarditis by a multidisciplinary team.

DESIGN: Single-center, retrospective cohort study.

METHODS: Patient cases were identified from the registry of the institutional multidisciplinary endocarditis team. Patients with left-sided endocarditis, multivalvular endocarditis, prosthetic tricuspid valves and cardiac implantable electronic devices were excluded.

RESULTS: Between September 7th, 2021 and February 1st, 2024 72 consecutive patients with isolated native tricuspid valve infective endocarditis were identified. Sixty-six (91.7%) patients were managed medically. Five patients underwent percutaneous mechanical aspiration of tricuspid valve vegetations and one patient underwent tricuspid valve replacement during the index hospitalization. In-hospital mortality was 1.4% and 90-day mortality was 2.8%. Nineteen (26.4%) patients discharged before medically advised and 25% were re-admitted within 30 days. Ten (13.9%) patients underwent elective tricuspid valve replacements after outpatient follow-up.

CONCLUSION: Among 72 patients with isolated native tricuspid valve infective endocarditis managed by a multidisciplinary endocarditis program over a 2.5-year period, in-hospital, 90-day mortality and 1-year mortality were very low despite low rates of percutaneous mechanical aspiration and tricuspid valve surgery. Multidisciplinary follow-up can lead to elective tricuspid valve surgery in a delayed fashion.

Publisher or Conference

Therapeutic Advances in Infectious Disease

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