Infective Endocarditis Secondary to Injection Drug Use: A Survey of Canadian Cardiac Surgeons.
Ann Thorac Surg
; 112(5): 1460-1467, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-33358887
ABSTRACT
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.
Texto completo:
1
Coleções:
01-internacional
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
País de afiliação:
Canadá