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. 2025 Apr 25;12(5):ofaf259.
doi: 10.1093/ofid/ofaf259. eCollection 2025 May.

Comparison of Outcomes of Percutaneous Mechanical Aspiration vs Tricuspid Valve Surgery in Drug Use-Associated Endocarditis of the Tricuspid Valve

Madeleine Purcell  1 , Sergey Gnilopyat  1 , Bhargav Makwana  2 , Shivakumar Narayanan  3
Affiliations

Comparison of Outcomes of Percutaneous Mechanical Aspiration vs Tricuspid Valve Surgery in Drug Use-Associated Endocarditis of the Tricuspid Valve

Madeleine Purcell et al. Open Forum Infect Dis. .

Abstract

Background: People who inject drugs (PWID) and present with infective endocarditis (IE) of the tricuspid valve may need valve surgery due to persistent infection, heart failure, or embolic risk. Vacuum-assisted percutaneous mechanical aspiration (PMA) has been proposed as a potential option for those who cannot undergo surgery.

Methods: We queried TriNetX, a database that provides access to electronic medical record data across health care organizations, to identify PWID who had tricuspid valve IE and underwent PMA between 2016 and 2024, using diagnostic and procedure codes. Short-term procedural and clinical outcomes were compared with PWID who underwent tricuspid valve surgery.

Results: In total, 129 patients underwent the PMA procedure and 952 had valve surgery. A higher proportion of the PMA cohort was female (66% vs 57%) and of non-White race (32% vs 22.5%). At 1 month postprocedure, the surgical group had a lower rate of death (2.5% vs 7.9%, P = .001), while the PMA group had a lower risk of heart block or need for pacemaker implantation (0% vs 4%). After propensity matching between groups, these differences were not significant. At 1 year postprocedure, groups had similar rates of heart failure, tricuspid insufficiency, or offer of treatment intervention for opioid use disorder.

Conclusions: Short-term outcomes seem comparable between PMA and tricuspid valve surgery in tricuspid valve IE in PWID. Additional studies with larger cohort numbers are needed to further evaluate the difference in long-term postoperative outcomes between the groups.

Keywords: AngioVac; PWID; percutaneous mechanical aspiration; tricuspid endocarditis; tricuspid valve replacement.

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Conflict of interest statement

Potential conflicts of interest. S. N. reports investigator-initiated grant funding from Melinta Therapeutics. All other authors report no potential conflicts.

Figures

Graphical Abstract
Graphical Abstract
This graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/comparison-of-outcomes-of-percutaneous-mechanical-aspiration-versus-tricuspid-valve-surgery-in-drug-use-associated-endocarditis-of-the-tricuspid-valve?utm_campaign=tidbitlinkshare&utm_source=IO
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References

    1. Lansky A, Finlayson T, Johnson C, et al. Estimating the number of persons who inject drugs in the United States by meta-analysis to calculate national rates of HIV and hepatitis C virus infections. PLoS One 2014; 9:e97596. - PMC - PubMed
    1. Bradley H, Hall EW, Asher A, et al. Estimated number of people who inject drugs in the United States. Clin Infect Dis 2023; 76:96–102. - PMC - PubMed
    1. Wurcel AG, Anderson JE, Chui KKH, et al. Increasing infectious endocarditis admissions among young people who inject drugs. Open Forum Infect Dis 2016; 3:ofw157. - PMC - PubMed
    1. Schranz A, Barocas JA. Infective endocarditis in persons who use drugs: epidemiology, current management, and emerging treatments. Infect Dis Clin North Am 2020; 34:479–93. - PMC - PubMed
    1. Schranz AJ, Fleischauer A, Chu VH, Wu L-T, Rosen DL. Trends in drug use–associated infective endocarditis and heart valve surgery, 2007 to 2017: a study of statewide discharge data. Ann Intern Med 2019; 170:31–40. - PMC - PubMed