Opioid epidemic leads to more, younger people having heart valve operations

The opioid epidemic in the U.S. is becoming a bigger problem medically, socially and financially, and the COVID-19 pandemic has made it worse, according to the Food and Drug Administration.

Heart surgeons have seen a disturbing trend over the past decade: more and younger patients with infective endocarditis requiring heart surgery. Infective endocarditis is an infection caused by bacteria that get into the bloodstream and settle in the heart lining or a heart valve. IV drug use can introduce aggressive bacteria that can quickly and severely injure heart valves.

Juan Crestanello, M.D., a Mayo Clinic cardiovascular surgeon, has insights into this trend. Dr. Crestanello is senior author on a multicenter study that looked at nearly 35,000 valve operations for infective endocarditis from 2011 to 2018.

Study highlights include:

  • More than one-third of heart valve operations were for infective endocarditis related to drug use.
  • There was a more than twofold increase in valve operation in this category of patients.
  • There were regional differences, with the greatest increases found in the East South Central and South Atlantic regions, and New England.
  • Patients with infective endocarditis related to drug use were typically younger, with a median age of 36. They also had a higher rate of smoking, drinking and liver disease. And they were more likely to need emergency surgery, and be on Medicaid or uninsured.
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