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Operative treatment of infective endocarditis in children
1Center of Pediatric Cardiology and Cardiac Surgery, University Hospital Motol, Prague, Czechoslovakia.
Insights
Surgical treatment for childhood infective endocarditis, often linked to congenital heart defects, is feasible. Surgery achieved good outcomes in most pediatric patients, even during active infection.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Infectious Diseases
Background:
- Infective endocarditis in children is frequently associated with congenital heart defects.
- Medical management is not always successful, necessitating surgical intervention.
Purpose of the Study:
- To evaluate the feasibility and outcomes of surgical treatment for infective endocarditis in pediatric patients.
- To assess the safety and efficacy of surgical debridement and repair in this population.
Main Methods:
- Retrospective review of 11 children (2 months to 15 years) who underwent surgery for infective endocarditis.
- Surgical procedures included debridement of infected tissue and repair of congenital heart defects.
- Analysis of postoperative complications and long-term hemodynamic results.
Main Results:
- Surgery was feasible and successful in 10 out of 11 pediatric patients.
- No septic complications occurred postoperatively, even in 8 patients operated on during active infection.
- Long-term follow-up (median 39 months) showed good hemodynamic results (NYHA class I) in 10 patients, including 4 with prosthetic valves.
Conclusions:
- Surgical intervention is a viable treatment option for pediatric infective endocarditis, particularly when secondary to congenital heart disease.
- The study highlights the safety of operating during active infection and the potential for good long-term outcomes with surgical repair or valve replacement.
Abstract:
A retrospective review of 11 children, aged 2 months to 15 years, demonstrates the feasibility of surgical treatment for infective endocarditis in childhood. Except for one case of perinatal infection, in all instances the infective endocarditis was a complication of a congenital heart defect. As medical treatment was not successful, surgery was indicated. Debridement of infected tissue and repair of the congenital heart defect was performed. There were no septic complications postoperatively although 8 patients were operated upon during the active stage of infection. One 2-month-old child did not survive excision of an infected tricuspid valve. The follow-up period of 8 years to 5 months (median 39 months) showed a good haemodynamic result (NYHA class I) in the remaining 10 patients. This included 4 patients with prosthetic valves.