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Infective Endocarditis Secondary to Injection Drug Use: A Survey of Canadian Cardiac Surgeons.
An, Kevin R; Luc, Jessica G Y; Tam, Derrick Y; Dagher, Olina; Eikelboom, Rachel; Bierer, Joel; Cartier, Andréanne; Vo, Thin X; Vaillancourt, Olivier; Forgie, Keir; Elbatarny, Malak; Gao, Sophie Weiwei; Whitlock, Richard; Lamba, Wiplove; Arora, Rakesh C; Adams, Corey; Yanagawa, Bobby.
Afiliação
  • An KR; Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, Canada.
  • Luc JGY; Division of Cardiovascular Surgery, University of British Columbia, Vancouver, Canada.
  • Tam DY; Division of Cardiovascular Surgery, University of British Columbia, Vancouver, Canada.
  • Dagher O; Division of Cardiac Surgery, University of Calgary, Calgary, Canada.
  • Eikelboom R; Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
  • Bierer J; Division of Cardiac Surgery, Dalhousie University, Halifax, Canada.
  • Cartier A; University of Laval Faculty of Medicine, Quebec City, Canada.
  • Vo TX; Division of Cardiac Surgery, University of Ottawa Heart Institute, University of Ottawa, Ottawa, Canada.
  • Vaillancourt O; Division of Cardiac Surgery, McGill University, Montreal, Canada.
  • Forgie K; Division of Cardiac Surgery, University of Alberta, Edmonton, Canada.
  • Elbatarny M; Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, Canada.
  • Gao SW; Division of Cardiac Surgery, McMaster University, Hamilton, Canada.
  • Whitlock R; Division of Cardiac Surgery, McMaster University, Hamilton, Canada.
  • Lamba W; Division of Psychiatry, St. Michael's Hospital, University of Toronto, Toronto, Canada.
  • Arora RC; Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
  • Adams C; Division of Cardiac Surgery, University of Calgary, Calgary, Canada.
  • Yanagawa B; Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, Canada. Electronic address: yanagawab@smh.ca.
Ann Thorac Surg ; 112(5): 1460-1467, 2021 11.
Article em En | MEDLINE | ID: mdl-33358887
BACKGROUND: Injection drug use-associated infective endocarditis (IDU-IE) is a growing epidemic. The objective of this survey was to identify the beliefs and practice patterns of Canadian cardiac surgeons regarding surgical management of IDU-IE. METHODS: A 30-question survey was developed by a working group and distributed to all practicing adult cardiac surgeons in Canada. Data were analyzed using descriptive statistics. RESULTS: Of 146 surgeons, 94 completed the survey (64%). Half of surgeons (49%) would be less likely to operate on patients with IE if associated with IDU. In the case of prosthetic valve IE owing to continued IDU, 36% were willing to reoperate once and 14% were willing to reoperate twice or more. Most surgeons required commitments from patients before surgery (73%), and most referred patients to addiction services (81%). Some surgeons would offer a Ross procedure (10%) or homograft (8%) for aortic valve IE, and 47% would consider temporary mechanical circulatory support. Whereas only 17% of surgeons worked at an institution with an endocarditis team, 71% agreed that there was a need for one at each institution. Most surgeons supported the development of IDU-IE-specific guidelines (80%). CONCLUSIONS: Practice patterns and surgical management of IDU-IE vary considerably across Canada. Areas of clinical unmet needs include the development of a formal addiction services referral protocol for patients, the development of an interdisciplinary endocarditis team, as well as the creation of IDU-IE clinical practice guidelines.
Assuntos

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 2_ODS3 Base de dados: MEDLINE Assunto principal: Cirurgia Torácica / Padrões de Prática Médica / Abuso de Substâncias por Via Intravenosa / Endocardite Tipo de estudo: Guideline / Qualitative_research Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: Ann Thorac Surg Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 2_ODS3 Base de dados: MEDLINE Assunto principal: Cirurgia Torácica / Padrões de Prática Médica / Abuso de Substâncias por Via Intravenosa / Endocardite Tipo de estudo: Guideline / Qualitative_research Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: Ann Thorac Surg Ano de publicação: 2021 Tipo de documento: Article