**4. Current data**

*Advanced Concepts in Endocarditis - 2021*

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**3.5 Indications**

*AngioVac placement and configuration.*

**Figure 4.**

The surgical indications for TVE are less clear than that of endocarditis involving the left side of the heart. Current indications for surgery include vegetations >2 cm, evidence of septic pulmonary emboli, methicillin resistant organism, fungal infections and structural deterioration causing severe tricuspid valve regurgitation and heart failure [21]. However, given the repeat IVDU in these patients a surgical treatment is less likely to last for long due to repeat episodes of TVE. More concerning is the potential of prosthetic valve endocarditis which almost always necessitates a reoperation. Surgeons often find themselves in an ethical dilemma when patients represent needing a reoperation, especially when they have failed a second or third time. The risk of reoperation steadily increases and at some point, the risks outweigh the benefits.
