Wallen Tyler J, Szeto Wilson, Williams Matthew, Atluri Pavan, Arnaoutakis George, Fults Marci, Sultan Ibrahim, Desai Nimesh, Acker Michael, Vallabhajosyula Prashanth
Mercy Catholic Medical Center, Darby, Pennsylvania.
The University of Pennsylvania Health System, Philadelphia, Pennsylvania.
J Card Surg. 2018 May;33(5):260-264. doi: 10.1111/jocs.13600. Epub 2018 Apr 16.
We reviewed our institutional experience with tricuspid valve endocarditis to understand the impact of the opioid epidemic on the incidence of right heart endocarditis.
We retrospectively reviewed all cases of tricuspid endocarditis managed surgically from January of 2011 to May of 2017. There were no exclusion criteria.
A total of 126 patients were identified. There were seven cases in 2011 and 36 in 2016. The average age of the patients decreased from 52.85 ± 19.6 years in 2011 to 39.2 ± 12.9 in 2017. Caucasians comprised 71% of the patients in 2011 and 75% in 2016. Tricuspid valve replacement was performed in 74 patients (58.73%) and repair was performed in 52 (41.27%). Thirty-day mortality was 11.11%. Reoperation, stroke and renal failure requiring dialysis during the index hospitalization were 5.6%, 0.8%, and 8%, respectively. Staphylococcus aureus, found in 43% of cases, was the most common isolate throughout the study period. Streptococcus was the second most common causative agent.
In a span of 5 years, our institution has noted a fivefold increase in surgical volume for tricuspid endocarditis, most likely related to the impact of the opioid epidemic.
我们回顾了本机构治疗三尖瓣心内膜炎的经验，以了解阿片类药物流行对右心内膜炎发病率的影响。
我们回顾性分析了2011年1月至2017年5月期间所有接受手术治疗的三尖瓣心内膜炎病例。无排除标准。
共确定126例患者。2011年有7例，2016年有36例。患者的平均年龄从2011年的52.85±19.6岁降至2017年的39.2±12.9岁。白种人在2011年占患者的71%，在2016年占75%。74例患者（58.73%）进行了三尖瓣置换术，52例（41.27%）进行了修复术。30天死亡率为11.11%。在首次住院期间再次手术、中风和需要透析的肾衰竭发生率分别为5.6%、0.8%和8%。在整个研究期间，43%的病例中发现金黄色葡萄球菌是最常见的分离菌株。链球菌是第二常见的病原体。
在5年的时间里，我们机构注意到三尖瓣心内膜炎的手术量增加了五倍，这很可能与阿片类药物流行的影响有关。
