Key result
Tricuspid valvectomy and bidirectional Glenn shunt resolve relapsing tricuspid endocarditis in a single case.
Why the study?
Eradication of tricuspid valve endocarditis in patients with ongoing intravenous drug abuse is challenging due to high postoperative mortality and recurrence rates.
Case Report (n=1)
No
Bidirectional Glenn shunt combined with tricuspid valvectomy can serve as a salvage surgical strategy for recurrent tricuspid endocarditis in patients with active intravenous drug abuse.
Answers are grounded in this paper and cite their sources.
May warrant consideration in refractory tricuspid endocarditis; leaves open confirmation in prospective trials.
Tricuspid valve endocarditis has potential associations with various conditions, but it is commonly related to intravenous drug abuse. Often, its eradication can become very challenging due to high post-operative mortality and high rate of recurrence due to persistence of drug abuse habits. The bidirectional Glenn shunt (BGS), typically employed in congenital heart surgery, combined with tricuspid valvectomy, has occasionally been used for recurrent endocarditis. Herein, we present a 31-year-old woman with drug addiction scheduled for her fourth reintervention due to the early degeneration and infection of a previous pulmonary homograft used for recurring tricuspid valve endocarditis. The final surgical strategy was valvectomy and BGS, aimed at eliminating all potential sources of infection and providing more time for the patient to overcome drug addiction, enabling further treatment if necessary.
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Boschetti et al. (2026) conducted a case report in Relapsing tricuspid endocarditis (n=1). Tricuspid valvectomy and bidirectional Glenn shunt (BGS) was evaluated on Resolution of infection and clinical improvement. Tricuspid valvectomy combined with a bidirectional Glenn shunt successfully eradicated infection and improved symptoms to functional class II at one-year follow-up in a patient with relapsing tricuspid endocarditis.
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