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Infective endocarditis of the Dacron patch-a report of 13 cases at autopsy

Pradeep Vaideeswar1, Prashant Mishra, Manglesh Nimbalkar

  • 1Department of Pathology (Cardiovascular and Thoracic Division), Seth G.S. Medical College and KEM Hospital, Mumbai, India. shreeprajai@yahoo.co.in

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
|September 7, 2010
PubMed
Abstract

Insights

Dacron patch infection, a complication of congenital heart defect repair, can lead to infective endocarditis. This autopsy study of 13 patients highlights the challenges in treating these difficult infections.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Pathology

Background:

  • Synthetic patches, like Dacron, are used to repair congenital heart defects (left-to-right shunts).
  • Infection of these synthetic patches (Dacron-patch infective endocarditis) is a serious postoperative complication.

Purpose of the Study:

  • To report on autopsy findings in patients who developed Dacron-patch infective endocarditis.
  • To analyze the characteristics and outcomes of this rare complication.

Main Methods:

  • Retrospective review of autopsy records from 1994-2008.
  • Selection of 13 cases with Dacron-patch infective endocarditis.
  • Classification into early-onset and late-onset cases.

Main Results:

  • Infective endocarditis occurred in 13 patients (9 males, 4 females; mean age 13.1 years) after atrial or ventricular septal defect repair.
  • Episodes occurred 2-118 days post-operation (mean 30 days), with 10 early-onset and 3 late-onset cases.
  • Commonly isolated organisms included Staphylococcus aureus, gram-positive cocci, Pseudomonas, Aspergillus, and Candida species. Death resulted from embolization or septicemia.

Conclusions:

  • Congenital cardiac defect repair using synthetic materials can create substrates for infective endocarditis.
  • Dacron-patch infective endocarditis is a challenging complication that is often difficult to treat.

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