Imaging

Cardiology

Advocacy

Canadian Society of Echocardiography (CSE)

215 - STABILIZATION, SURGERY, AND SUCTION DEVICES IN DRUG-USE ASSOCIATED ENDOCARDITIS: AN ENDOCARDITIS TEAM APPROACH TO CHALLENGING CASES

Co-Chair(s)

• 

  Robin Ducas, MD, FRCPC, DRCPSC

  Dr.
  University of Manitoba
  University of Manitoba
• 

  Lawrence Lau, MD

  Cardiologist
  University of Ottawa
  University of Ottawa Heart Institute

Panelist(s)

• TC

  Taliesin Cahill, BN, MSN
• 

  Sami El-Dalati, MD (he/him/his)

  Associate Professor
  University of Kentucky
  University of Kentucky
• BL

  Benjamin Leis, MD, MSc, FRCPC

  General Cardiology
  Division of Cardiology, Department of Medicine, University of Saskatchewan
• VW

  Victoria Weaver, MD
• 

  Bobby Yanagawa, MD, PhD

  Cardiac Surgeon
  St. Michael's Hospital
  Program Director and Associate Professor, University of Toronto

Presenter(s)

• TC

  Taliesin Cahill, BN, MSN
• 

  Sami El-Dalati, MD (he/him/his)

  Associate Professor
  University of Kentucky
  University of Kentucky
• BL

  Benjamin Leis, MD, MSc, FRCPC

  General Cardiology
  Division of Cardiology, Department of Medicine, University of Saskatchewan
• RS

  Rohan Sanjanwala, MD
• SS

  Serah Seo, BA

  Medical student
  University of Ottawa
• 

  Bobby Yanagawa, MD, PhD

  Cardiac Surgeon
  St. Michael's Hospital
  Program Director and Associate Professor, University of Toronto

Early Career(s)

• 

  Sami El-Dalati, MD (he/him/his)

  Associate Professor
  University of Kentucky
  University of Kentucky
• 

  Lawrence Lau, MD

  Cardiologist
  University of Ottawa
  University of Ottawa Heart Institute

Trainee(s)

• RS

  Rohan Sanjanwala, MD
• SS

  Serah Seo, BA

  Medical student
  University of Ottawa

Moderator(s)

• 

  Lawrence Lau, MD

  Cardiologist
  University of Ottawa
  University of Ottawa Heart Institute

Planning Committee Member(s)

• VC

  Vincent Chan, MD MPH

  Cardiac Surgeon
  University of Ottawa Heart Institute - Ottawa, ON
• 

  Sami El-Dalati, MD (he/him/his)

  Associate Professor
  University of Kentucky
  University of Kentucky
• 

  Lawrence Lau, MD

  Cardiologist
  University of Ottawa
  University of Ottawa Heart Institute
• BL

  Benjamin Leis, MD, MSc, FRCPC

  General Cardiology
  Division of Cardiology, Department of Medicine, University of Saskatchewan
• RS

  Rohan Sanjanwala, MD
• LS

  Luke Strnad, MD

Workshop Description: Drug-use associated infective endocarditis (DUA-IE) poses a unique challenge to cardiovascular specialists. While DUA-IE is associated with lower mortality than non-DUA-IE, several other factors complicate its management. Inadequate treatment of drug addiction, complicated psychosocial needs with insufficient support, and the pervasive negative stigma in the healthcare system contribute to higher rates of disease relapse and poor long-term outcomes. Furthermore, patients with DUA-IE often have complex healthcare needs that require multidisciplinary team collaboration. For example, when a patient with DUA-IE is admitted to a cardiovascular service, their heart failure is expertly managed by cardiovascular specialists. However, addressing the underlying substance use disorder and infection requires close collaboration with our colleagues in infectious diseases and addiction medicine. As cardiovascular specialists, we depend on their expertise to provide comprehensive care. Similarly, deciding to provide surgery in these cases poses additional challenges. While right-sided endocarditis is often better tolerated than left-sided infections, the risk of reinfection with a prosthetic valve due to ongoing drug use is a significant concern. These risks and therapeutic challenges require careful consideration and a multidisciplinary approach to ensure the best possible outcomes for these patients.
This workshop provides attendees with a unique opportunity to see how an Infective Endocarditis Team works in real-time. Through multiple complex case discussions, participants will experience the collaborative decision-making process, observing how cardiovascular specialists, infectious disease experts, addiction medicine specialists, and surgeons collaborate to develop a comprehensive treatment plan. In addition, a special emphasis will be placed on the critical question that interventional cardiologists and surgeons often face: when and in whom to use vacuum-assisted vegetation debulking, versus other options like conservative therapy or surgical debridement.
Panelists, who bring practical experience in leading Endocarditis Teams and treating DUA-IE, will share integrated strategies for managing complications, selecting appropriate antibiotic and addiction treatments, and developing treatment pathways that enhance access to surgery and social support for these high-risk patients.
Through this immersive experience, attendees will gain a deeper understanding of the collaborative, multidisciplinary approach required to manage DUA-IE effectively and improve patient outcomes.