Tricuspid valve endocarditis in the era of the opioid epidemic

BACKGROUND AND AIM: We reviewed our institutional experience with tricuspid valve endocarditis to understand the impact of the opioid epidemic on the incidence of right heart endocarditis. METHODS: We retrospectively reviewed all cases of tricuspid endocarditis managed surgically from January of 2011 to May of 2017. There were no exclusion criteria. RESULTS: 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. CONCLUSIONS: 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.