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High incidence of infective endocarditis in adults with congenital ventricular septal defect

Elisabeth Berglund1, Bengt Johansson1, Mikael Dellborg2

  • 1Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

Heart (British Cardiac Society)
|July 23, 2016
PubMed

Insights

Adults with small ventricular septal defects (VSDs) face a significantly higher risk of infective endocarditis (IE). However, mortality from IE in these patients with VSD is low.

Area of Science:

  • Cardiology
  • Infectious Diseases

Background:

  • Congenital Ventricular Septal Defects (VSDs) often require intervention if hemodynamically significant, while small shunts are typically managed conservatively.
  • Despite a generally good long-term prognosis, adults with VSD remain susceptible to long-term complications.

Purpose of the Study:

  • To determine the incidence of infective endocarditis (IE) in adult patients diagnosed with Ventricular Septal Defects (VSD).

Main Methods:

  • Utilized the Swedish registry for congenital heart disease (SWEDCON) to identify 779 adults with VSD (531 small shunts, 248 previously closed).
  • Cross-referenced with the National Patient Register to track hospitalizations for IE over a 10-year period.

Main Results:

  • Sixteen patients (2%) were treated for IE, with an incidence 20-30 times higher in unoperated VSD patients compared to the general population.
  • Thirteen patients with small, unoperated VSDs developed IE with no mortality.
  • Three patients with repaired VSDs (two with prior aortic valve replacement, one with a bicuspid aortic valve) developed IE, requiring reoperation and resulting in one death.

Conclusions:

  • Small, unoperated Ventricular Septal Defects (VSDs) in adults are associated with a substantially increased risk of infective endocarditis (IE).
  • Despite the elevated IE risk, mortality associated with IE in this population is low.
Abstract

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