title: Should patients who use illicit drugs be offered a second heart-valve replacement?
abstract: Intravenous drug users (IVDUs) have an elevated risk of contracting infectious endocarditis. Most of them have good effect from medical treatment, but some will need valve replacement. Until a few years ago, our hospital withheld valve surgery if patients with intravenous drug dependency and infectious endocarditis came to need a second valve replacement. However, there are no consensus guidelines for treatment of this group of patients, and a dearth of data on the effects and benefits of interventions. Using a method of ethical analysis, we here discuss whether it is appropriate to offer valve surgery to drug users for a second time.
authors: Department of Research and Development, Helse Bergen Hospital Trust, Norway. ingrid.miljeteig@isf.uib.no
authors: Ingrid
authors: I
authors: Miljeteig
authors: Steinar
authors: S
authors: Skrede
authors: Jørund
authors: J
authors: Langørgen
authors: Rune
authors: R
authors: Haaverstad
authors: Ola
authors: O
authors: Jøsendal
authors: Haakon
authors: H
authors: Sjursen
authors: Ole Frithjof
authors: OF
authors: Norheim
mesh_terms: D001021:Aortic Valve / Q000601:surgery; D004697:Endocarditis, Bacterial / Q000209:etiology / Q000601:surgery; D026689:Ethical Analysis / Q000379:methods; D015276:Health Care Rationing / Q000941:ethics; D019918:Heart Valve Prosthesis Implantation / Q000941:ethics*; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects* / Q000941:ethics; D012086:Reoperation / Q000941:ethics*; D015819:Substance Abuse, Intravenous / Q000150:complications*