Excision of the tricuspid valve followed by delayed bioprosthetic replacement can be a viable strategy for severe staphylococcal endocarditis in drug users.
May support staged tricuspid excision in refractory endocarditis; hypothesis-generating and requires prospective validation before wider use.
Staphylococcal endocarditis in a drug addict was controlled only after excision of the tricuspid valve. Total absence of the tricuspid valve was tolerated well for 18 months, at which time deteriorating liver function prompted the insertion of a bioprosthetic valve into the tricuspid ring. The haemodynamic and clinical results after two years of follow-up have been excellent.
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Wright et al. (1978) studied this question.
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