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Infective endocarditis in congenital heart disease: Japanese national collaboration study

K Niwa1, M Nakazawa, S Tateno

  • 1Department of Paediatrics, Chiba Cardiovascular Centre, Ichihara, Chiba, Japan. kniwa@aol.com

Heart (British Cardiac Society)
|May 17, 2005
PubMed

Insights

Infective endocarditis (IE) in patients with congenital heart disease (CHD) has a high complication rate. This study provides data to inform future management guidelines for IE in pediatric and adult CHD patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Congenital heart disease (CHD) patients are at increased risk for infective endocarditis (IE).
  • There is a need for updated management guidelines due to recent increases in IE incidence and associated complications.

Purpose of the Study:

  • To establish pure cohorts of pediatric and adult patients with CHD and IE.
  • To gather data for the development of future clinical guidelines for IE management in CHD patients.

Main Methods:

  • A Japanese nationwide survey was conducted across 66 institutions.
  • Data were collected from 170 children and 69 adults diagnosed with IE between 1997 and 2001.
  • Clinical presentation, treatments, complications, and outcomes of IE were analyzed.

Main Results:

  • 119 patients had prior cardiac surgery, often preceded by dental procedures or cardiovascular surgery.
  • Common complications included embolic events (31%) and cardiac failure (23%). Streptococci and staphylococci were the most frequent pathogens.
  • Surgery during active IE was performed in 26% of cases, with vegetation and heart failure as primary indications. Overall mortality was 8.8%.

Conclusions:

  • The high incidence, mortality, and complication rates of IE in CHD patients necessitate well-formulated management recommendations.
  • This nationwide multicenter database provides valuable insights for establishing evidence-based guidelines for IE in pediatric and adult CHD populations.
Abstract

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