Risk of Reoperative Valve Surgery for Endocarditis Associated with Drug Use

Abstract Background We aimed to quantify incidence and operative risks associated with reoperative valve surgeries (RVS) in patients with drug-associated infective endocarditis (IE) in a multi-center setting. Methods We formed a registry of patients with drug-associated IE who underwent valve surgeries at 8 U.S. centers between 2011-2017. Outcomes of first-time valve surgery (FVS) and RVS were compared. Multivariable logistic regression models related RVS to 30-day mortality. Poisson regression models were fitted to evaluate temporal trends in overall case volume and proportions of patients undergoing RVS. Results The cohort consisted of 925 patients with drug-associated IE who underwent a valve surgery, of which 652 were FVS and 273 were RVS. Patients undergoing FVS had fewer comorbidities than those undergoing RVS. Overall case volume increased from 108 in 2012 to 229 cases in 2017 (p Conclusions Increasing proportion of valve surgery for drug-associated IE is for RVS. Despite being young and harboring few comorbidities, the RVS cohort is still susceptible to increased risk of 30-day mortality compared to those undergoing FVS.