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ORIGINAL ARTICLE
Year : 2021  |  Volume : 11  |  Issue : 4  |  Page : 229-235

Surgeons' re-operative valve replacement practices in patients with endocarditis due to drug use


1 Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA
2 Graduate Medical Education, HCA Healthcare, Physician Services Group, Denver, USA
3 President, Diagnosis Well, Greenwood Village, CO, Memphis TN, USA
4 Director of Research and Special Projects, William Novick Global Cardiac Alliance, Memphis TN, USA

Correspondence Address:
Dr. Julie M Aultman
Department of Family and Community Medicine,Northeast Ohio Medical University, Rootstown, Ohio 44272
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJCIIS.IJCIIS_195_20

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Background: This study discerns surgeons' attitudes and practices in the determination of heart valve replacement for patients with infectious endocarditis (IE) due to intravenous drug use (IVDU). We aimed to identify the factors contributing to surgeons' decision-making process for initial and recurrent surgical heart valves and the availability of institutional guidance. Methods: An IRB-approved, anonymous mixed-methods, open survey instrument was designed and validated with 24 questions. A convenience sample of cardiothoracic surgeons in the United States and globally resulted in a total of 220 study participants with 176 completing every question on the survey. Results: A cluster analysis revealed that although surgeons can be divided into subgroups based on their previous experience with valve replacements, these groups are not perfectly homogenous, and the number of identified clusters is dependent on technique used. Analysis of variance revealed the variables that most clearly divided the surgeons into subgroups were, in order of importance, years of practice, number of valve replacements, and geography. Conclusions: Our analysis showed heterogeneity among cardiothoracic surgeons regarding how they make clinical decisions regarding re-operative valve replacement related to IE-IVDU. Therefore, an opportunity exists for interprofessional teams to develop comprehensive guidelines to decrease variability in surgical decision-making regarding valve replacement associated with IE-IVDU.


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