Abstract
With the rising prevalence of drug abuse, increasing placement of intravascular catheters and use of implantable cardiac devices, the epidemiology and nature of right sided endocarditis (RSE) has changed over the course of years. RSE due to intravenous drug abuse (IVDU) is an important public health issue and can cause significant economic burden on healthcare facilities. It poses its own unique challenges due to the demographic of the population it affects. Late and varied presentations, lack of access to healthcare and support systems, non-compliance, and ongoing use of drugs, requires a superior logistical and coordinated approach unique to this subset of population to attain good outcomes. While not a novel disease, longstanding controversies with regards to antibiotic regimens, timing of as well as the type of surgery remain. There is paucity of data around outcomes with different treatment modalities. Optimal guidelines for RSE among IVDU are yet to defined. We will examine the predictors of high mortality, with a focus on identifying early, patients that will benefit from surgical management. We will review the available evidence on the outcomes data and efficacy of various surgical interventions that have been described.
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