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A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was what the long-term results of cardiac valve replacements are in left sided endocarditis with a history of i.v. drug abuse? A total of 286 publications were found using the reported search, of which nine presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patients group studied, study type, relevant outcomes, results, and study weaknesses of these papers were tabulated. We conclude that cardiac valve replacement for left sided endocarditis in i.v. drug users carries a substantial mortality. Continued drug abuse is the commonest cause of death in this patient group. In contrast, the type of valve used to perform the replacement does not seem to influence mortality. Postoperative management should focus on treatment of the drug addiction.

What are the long-term results of cardiac valve replacements in left sided endocarditis with a history of i.v. drug abuse?