Infective Endocarditis Secondary to Injection Drug Use: A Survey of Canadian Cardiac Surgeons Academic Article uri icon

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abstract

  • BACKGROUND: Injection drug use-associated infective endocarditis (IDU-IE) is a growing epidemic. The objective of this survey was to identify the beliefs and practice patterns of Canadian cardiac surgeons regarding surgical management of IDU-IE. METHODS: A 30-question survey was developed by a working group and distributed to all practicing adult cardiac surgeons in Canada. Data were analyzed using descriptive statistics. RESULTS: Of 146 surgeons, 94 completed the survey (64%). Half of surgeons (49%) would be less likely to operate on patients with IE if associated with IDU. In the case of prosthetic valve IE owing to continued IDU, 36% were willing to reoperate once and 14% were willing to reoperate twice or more. Most surgeons required commitments from patients before surgery (73%), and most referred patients to addiction services (81%). Some surgeons would offer a Ross procedure (10%) or homograft (8%) for aortic valve IE, and 47% would consider temporary mechanical circulatory support. Whereas only 17% of surgeons worked at an institution with an endocarditis team, 71% agreed that there was a need for one at each institution. Most surgeons supported the development of IDU-IE-specific guidelines (80%). CONCLUSIONS: Practice patterns and surgical management of IDU-IE vary considerably across Canada. Areas of clinical unmet needs include the development of a formal addiction services referral protocol for patients, the development of an interdisciplinary endocarditis team, as well as the creation of IDU-IE clinical practice guidelines.

authors

  • An, Kevin R
  • Luc, Jessica GY
  • Tam, Derrick Y
  • Dagher, Olina
  • Eikelboom, Rachel
  • Bierer, Joel
  • Cartier, Andréanne
  • Vo, Thin X
  • Vaillancourt, Olivier
  • Forgie, Keir
  • Elbatarny, Malak
  • Gao, Sophie Weiwei
  • Whitlock, Richard
  • Lamba, Wiplove
  • Arora, Rakesh C
  • Adams, Corey
  • Yanagawa, Bobby

publication date

  • November 2021