Collis Bennett, Alnabelsi Talal, Hall Evan, Cao Chloe, Johnson Meredith, Gurley John, Strnad Luke, Reda Hassan, London Tessa, Ogburn Erinn, Sekela Michael, Stoner Bobbi Jo, El-Dalati Sami
University of Kentucky College of Medicine, Lexington, KY, USA.
Division of Cardiology, Department of Internal Medicine, University of Kentucky Medical Center, Lexington, KY, USA.
Ther Adv Infect Dis. 2024 Sep 27;11:20499361241280690. doi: 10.1177/20499361241280690. eCollection 2024 Jan-Dec.
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.
To assess the clinical outcomes associated with management of native tricuspid valve infective endocarditis by a multidisciplinary team.
Single-center, retrospective cohort study.
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.
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.
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.
鉴于大量物质使用障碍患者的存在，孤立性原发性三尖瓣感染性心内膜炎仍然是一种难以治疗的疾病。关于最佳治疗策略以及多学科心内膜炎项目对该人群治疗结果的影响的数据有限。
评估多学科团队管理原发性三尖瓣感染性心内膜炎的临床结果。
单中心回顾性队列研究。
从机构多学科心内膜炎团队的登记册中识别患者病例。排除左侧心内膜炎、多瓣膜心内膜炎、人工三尖瓣和心脏植入式电子设备患者。
在2021年9月7日至2024年2月1日期间，连续确定了72例孤立性原发性三尖瓣感染性心内膜炎患者。66例（91.7%）患者接受药物治疗。5例患者在首次住院期间接受了经皮机械抽吸三尖瓣赘生物治疗，1例患者接受了三尖瓣置换术。住院死亡率为1.4%，90天死亡率为2.8%。19例（26.4%）患者在医嘱出院前出院，25%的患者在30天内再次入院。10例（13.9%）患者在门诊随访后接受了择期三尖瓣置换术。
在一个2.5年期间由多学科心内膜炎项目管理的72例孤立性原发性三尖瓣感染性心内膜炎患者中，尽管经皮机械抽吸和三尖瓣手术的发生率较低，但住院、90天死亡率和1年死亡率都非常低。多学科随访可导致择期三尖瓣手术延迟进行。
