Redo Endocarditis Case Study

1693 Words 7 Pages
Final Paper
The Dilemma of Devising a Policy for “Redo” Valvuloplasties in Recurrent Bacterial Endocarditis in Relapsing Intravenous Drug Users There has been an increasing incidence of intravenous (IV) heroin usage and overdoses in Ohio over the past 15 years. With it, hospitals in the state are seeing a substantial influx of medical complications related to IV heroin abuse. Infective endocarditis (IE) is one of the most severe, potentially life-threatening, complications for IV drug abuse with an inpatient mortality of 15-20% and a 1-year mortality of approximately 40%.1Once the bacteria infect the blood, they can adhere to cardiac structures creating infectious erosive masses which can lead to valvular insufficiency, stroke-causing
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While some cardiac surgeons or cardiologists feel it is not their role to decide whether or not they should operate on these patients. Most would not argue that clinicians should be good stewards of medical care and to not utilize valued resources when they would likely not result in much benefit. Indeed, health care is a limited resource and someone ultimately has to fund it. Inappropriate procedures or those that are likely futile not only lead to worse patient outcomes, but also to rising cost, can eventually limit access to …show more content…
Thuny F, Grisoli D, Collart F, Habib G, Raoult D. Management of infective endocarditis: Challenges and perspectives. Lancet. 2012;379:965-975
2. Hoen B, Duval X. Infective endocarditis. N Engl J Med. 2013;369:785
3. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, 3rd, Guyton RA, O 'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM, 3rd, Thomas JD, Members AATF. 2014 aha/acc guideline for the management of patients with valvular heart disease: A report of the american college of cardiology/american heart association task force on practice guidelines. Circulation.

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