“Dread to treat” patients in cardiac surgery: Global strategies for interacting with cardiothoracic patients with substance use disorders

Patients with substance use disorders (SUDs) who undergo valve repair or replacement are often readmitted to the hospital after discharge secondary to recidivism. These “dread to treat” patients pose a unique dilemma for cardiac surgeons who often must make the extremely difficult decision of whether to perform a valve replacement in a recidivist patient with SUDs. This editorial focuses on illuminating strategies which surgeons can administer to patients with SUDs to improve quality of care and reduce provider distress.