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Relapsing infective endocarditis following closure of ventricular septal defect

Sadahiro Sai1, Osamu Adachi, Yoshikatsu Saiki

  • 1Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan. sai@miyagi-children.or.jp

Asian Cardiovascular & Thoracic Annals
|February 29, 2012
PubMed

Insights

A child with recurrent Staphylococcus aureus endocarditis involving a Dacron patch underwent successful patch replacement with pericardium. This innovative approach resolved the infection, offering a promising solution for complex cardiac device infections.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Biomaterials Science

Background:

  • Ventricular septal defects (VSDs) are commonly repaired surgically.
  • Dacron patches are frequently used in cardiac defect repairs.
  • Recurrent infections pose significant challenges in patients with cardiac implants.

Observation:

  • An 8-year-old boy presented with recurrent methicillin-resistant Staphylococcus aureus (MRSA) infective endocarditis.
  • Echocardiography revealed vegetation on the tricuspid valve and a previously placed Dacron patch.
  • Lung abscesses were also present, indicating systemic spread of infection.

Findings:

  • The infected Dacron patch was surgically removed.
  • The patch was replaced with glutaraldehyde-treated autologous pericardium.
  • The patient experienced an uneventful recovery and remained infection-free for 4 years post-surgery.

Implications:

  • Autologous pericardium is a viable alternative for infected Dacron patch closure in pediatric cardiac surgery.
  • This case highlights a successful strategy for managing complex, relapsing infective endocarditis involving prosthetic materials.
  • Further research into biomaterial infection resistance and alternative patch materials is warranted.

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