International Journal for Multidisciplinary Research (IJFMR) E-ISSN: 2582-2160 ● Website: www.ijfmr.com ● Email: editor@ijfmr.com IJFMR23044628 Volume 5, Issue 4, July-August 2023 1 Indication and Timing of Surgery in Patients With Endocarditis of the Tricuspid Valve H. Kalkoul 1 , S. Lehachi 2 , M. Chettibi 3 Service de cardiologie Benimessous Alger, Algérie Abstract Endocarditis of the right heart is a particular form of infective endocarditis, it often affects intra venous (IV) drug addicts, it can be severe, its diagnosis is based on Duke's criteria, it can be complicated by pulmonary or paradoxical emboli which can sometimes worsen the clinical situation, in addition to antibiotics surgical treatment is sometimes necessary for recovery, the indication for which depends on several clinical, anatomical, and biological criteria. The aim of this review is to illustrate the indications and place of the different surgical methods in the management of tricuspid endocarditis, as well as the best time for the operation. Keywords : Tricuspid endocarditis, drug addiction, surgical criteria, optimal timing, prognosis. Introduction Infective endocarditis is a microbial infection invading the endocardium, which can cause major damage. To this day, it remains a difficult clinical entity, most often involving the left heart. The incidence of isolated infective endocarditis of the tricuspid valve has increased considerably in recent years, accounting for around 5-10% of cases of endocarditis [1], the majority of which occur in the context of intravenous drug use. Over 50% of cases of tricuspid IE are due to Staphylococcus aureus [2]. Medical management is the cornerstone of treatment, but surgery is required in a subset of patients. Surgical management of tricuspid valve endocarditis can be performed with satisfactory results. However, the optimal indication and timing of surgery remain uncertain, and the frequent association with intravenous drug abuse complicates management [3]. Observation We report the case of Mrs B. S, aged 31 years, admitted to the cardiology department of CHU Benimessous, for treatment of isolated tricuspid infective endocarditis. The patient presented with a clinical infectious syndrome (fever peaks at 40°C, progressive weight loss) 40 days after a laborious vaginal delivery, for which she received symptomatic treatment, but with no improvement. Subsequently, the patient developed signs of pneumopathy, prompting a chest CT scan, which revealed images suggestive of septic emboli, leading to her referral to the cardiology department of the Benimessous University Hospital, Algiers. The clinical examination revealed a murmur at the tricuspid focus, which led to a transthoracic echocardiogram. This revealed extensive damage to the tricuspid valve, with the appearance of very large mobile vegetation on the anterior valve, affecting the septum (Fig1- Fig2), causing significant tricuspid insufficiency (Fig3). The laboratory work-up was disturbed, with a severe infectious syndrome. The diagnosis of IE was made according to the Duke criteria. During her hospitalisation, the patient