[Infective endocarditis in adult patients with congenital heart disease. Experience from a reference centre]

Area of Science:

• Cardiology
• Infectious Diseases
• Adult Congenital Heart Disease

Background:

• Increasing adult population with congenital heart disease (CHD).
• Infective endocarditis (IE) is a significant complication in adults with CHD.
• Limited data on IE features in this specific demographic.

Purpose of the Study:

• To describe the clinical features of infective endocarditis (IE) in adult patients with congenital heart disease (CHD).
• To identify common etiologies, affected cardiac structures, and treatment outcomes.
• To inform management strategies for IE in this growing patient population.

Main Methods:

• Retrospective review of adult patients (≥16 years) with CHD and IE (modified Duke criteria) from 1996-2014.
• Analysis focused on the first IE episode per patient.
• Descriptive statistics to characterize patient demographics, CHD types, IE presentation, and outcomes.

Main Results:

• 27 adult CHD patients diagnosed with IE; median age 27.7 years, predominantly male (63%).
• Most common CHD: ventricular septal defect (33%); 41% had prosthetic material, 81% had residual defects.
• Right-sided IE (44%) was frequent, with viridans group streptococci and Staphylococcus epidermidis as primary pathogens.
• Surgery required in 37%; mortality was low (2 patients), primarily due to recurrence.

Conclusions:

• IE in adults with CHD typically affects young individuals with prosthetic material or residual defects.
• Right-sided IE is common, and while surgical intervention is often necessary, overall mortality is low.
• Relapses pose a significant risk, highlighting the need for vigilant follow-up and management.