Vegetectomy and tricuspid valvuloplasty may offer a promising reconstructive therapeutic alternative for selected cases of right-heart endocarditis in intravenous drug users.
Suggests reconstructive option for selected right-heart endocarditis in IV drug users; hypothesis-generating and should not change practice.
This report describes the case of a 24-year-old female heroin addict with large tricuspid valve vegetation, recurrent septic pulmonary emboli, and renal failure, due to immune-complex nephritis. The clinical course was initially complicated by acute hepatitis A. Because of recurrent emboli and persistent fever despite adequate antibiotic therapy she underwent excision of the vegetation ("vegetectomy") and tricuspid valvuloplasty. She was well at follow-up 12 months later with trivial tricuspid regurgitation shown by doppler-echocardiography. Kidney and liver function were normal. Right-heart endocarditis in drug addiction and therapeutic approaches are discussed. In selected cases "vegetectomy" and valvuloplasty offer a promising therapeutic alternative.
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Straumann et al. (1990) studied this question.
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