Ask HRC: Limiting Valve Replacement Surgeries for IV Drug Users

​A Healthcare Risk Control(HRC) member recently asked for guidance in developing a policy or guideline that would limit valve replacement surgeries for intravenous (IV) drug users who repeatedly present with endocarditis. The policy would limit these patients to a single replacement surgery.

In our response, we note the many issues to consider when deciding whether to provide only a single valve replacement surgery to a patient who is actively misusing drugs. Although guidelines specific to this topic are not available from relevant professional organizations, resources are available that address the...