title: Tricuspid Valve Replacement in an HIV-Infected Patient with Severe Tricuspid Regurgitation Secondary to Remote Endocarditis.
abstract: Surgical intervention for severe tricuspid regurgitation secondary to remote infective endocarditis has been infrequent, especially in patients also infected with the human immunodeficiency virus (HIV). We describe the case of a 62-year-old HIV-positive man, with a 24-year history of endocarditis caused by intravenous heroin use, who presented with severe tricuspid regurgitation. The patient was initially asymptomatic, was taking antiretroviral medications, and had a satisfactory CD4 count and an undetectable viral load, so we decided to manage the regurgitation conservatively. Two years later, he presented with biventricular heart failure and dyspnea. After surgical tricuspid valve replacement, his condition improved substantially. This case illustrates that HIV-infected patients with complex medical conditions can successfully undergo cardiac surgery.
authors.forename: Merle
authors.initials: M
authors.lastname: Myerson
authors.forename: Ehrin J
authors.initials: EJ
authors.lastname: Armstrong
authors.forename: Eduard
authors.initials: E
authors.lastname: Poltavskiy
authors.forename: Jose
authors.initials: J
authors.lastname: Fefer
authors.forename: Heejung
authors.initials: H
authors.lastname: Bang
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology; D018618:Echocardiography, Doppler, Color; D004696:Endocarditis / Q000150:complications* / Q000175:diagnosis; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D006333:Heart Failure / Q000209:etiology; D019918:Heart Valve Prosthesis Implantation; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D015819:Substance Abuse, Intravenous / Q000150:complications*; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
keywords: Disease management; HIV infections/complications; endocarditis, bacterial/physiopathology; heart valve diseases/complications/etiology/surgery/therapy; risk factors; treatment outcome; tricuspid valve/surgery