3. Conclusions

The incidence of tricuspid valve infective endocarditis is increasing along with the epidemic of intravenous drug use. Surgical treatment would be necessary when the patients suffer from heart failure, large vegetation, and persistent bacteremia despite appropriate antibiotic therapy. Tricuspid valve reconstruction is desirable as artificial material can be avoided; however, in cases of severe valve destruction, tricuspid valve replacement is warranted. Management of patients with intravenous drug users is challenging due to late recidivism, reinfection, and poor social situations. The operation for reinfection carries high risk. There is an ethical controversy regarding the surgical indication for reinfection induced by relapse of drug use. Surgeons can play a role by bringing the problem of epidemic of drug use to public consciousness.
