Related Experiment Video
Updated: Aug 4, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Current patterns of infective endocarditis in congenital heart disease
S Di Filippo1, F Delahaye, B Semiond
1Cardiologie Pediatrique, Hopital L Pradel, Lyons, France. sylvie.di.filippo@wanadoo.fr
Insights
Infective endocarditis in congenital heart disease patients is shifting towards complex cyanotic disease and prosthetic material repairs. Dental and skin infections are increasing causes, necessitating targeted prevention strategies.
Area of Science:
- Cardiology
- Infectious Diseases
- Pediatric Cardiology
Background:
- Infective endocarditis (IE) poses a significant risk in patients with congenital heart disease (CHD).
- Understanding the evolving epidemiology of IE in CHD is crucial for effective management and prevention.
Purpose of the Study:
- To analyze the changing trends and characteristics of infective endocarditis in patients with congenital heart disease over a 36-year period.
Main Methods:
- Retrospective review of 153 IE cases diagnosed between 1966 and 2001.
- Cases were categorized into two periods: pre-1990 (Period I) and post-1990 (Period II) using revised Duke criteria.
Main Results:
- The mean age of affected patients increased in Period II.
- Non-operated ventricular septal defects, Rastelli corrections, and palliated cyanotic heart disease became more prevalent.
- Dental issues remained a leading cause, while cutaneous infections increased; negative blood cultures decreased.
- Severe heart failure and cardiac complications reduced, with increased early surgery in Period II.
Conclusions:
- Current IE cases in CHD predominantly involve complex cyanotic disease, prosthetic material repairs, and small ventricular septal defects.
- While postoperative IE decreased, dental and cutaneous sources are rising, underscoring the need for enhanced prophylactic measures.
- Survival rates remained high and unchanged between periods, but targeted prevention is essential.
Objective:
To assess the changing profile of infective endocarditis in patients with congenital heart disease.
Methods:
All cases diagnosed from 1966 to 2001 (revised Duke criteria) were retrospectively reviewed and categorised in periods I (< 1990) and II (>or= 1990).
Results:
153 episodes occurred, 81 in period I and 72 in period II. Mean age of affected patients was higher in period II. Non-operated ventricular septal defect, Rastelli correction and palliated cyanotic heart disease increased. Infective endocarditis in corrective surgery changed to patients with prosthetic material. Post-surgical cases decreased. Dental problems were the leading cause (period I 20% v II 33% of cases) with a large variety of pathological organisms (multiple species of Streptococcus). Cutaneous causative infections increased (5% to 17%) with different species of Staphylococcus. Negative blood cultures lessened (20% to 7%, p = 0.03). Streptococci were the most common causative organisms in both periods. Severe heart failure and cardiac complications lessened (20% to 4% and 31% to 18% during periods I and II, respectively). Early surgery was more frequent in period II (32% v 18.5%, p = 0.02). One- and 10-year survival was 91% v 97% in period I and 89% v 97% in period II, respectively (NS).
Conclusion:
Current targets include complex cyanotic disease, congenital heart disease corrected with prosthetic material and small ventricular septal defect. Postoperative cases lessened; dental and cutaneous causes increased. Survival was unchanged. Prophylactic measures targeted at dental and cutaneous sources should be emphasised.
Related Concept Videos
01:25Endocarditis I: Introduction
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:18Endocarditis III: Medical Management
01:29Endocarditis IV: Nursing Management
01:23Rheumatic Heart Disease I: Introduction
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies