A 20-year study on treating childhood infective endocarditis with valve replacement in a single cardiac center in

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Jian Xiao1, Liang Yin1, Yiyun Lin2

  • 1Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China ;

Journal of Thoracic Disease
|August 9, 2016
PubMed

Insights

Pediatric infective endocarditis (IE) in China often requires valve replacement due to severe damage. Valve replacement surgery in children with IE shows optimal survival and re-operation rates, highlighting the need for early diagnosis to preserve native valves.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Infectious Diseases

Background:

  • Children in China with infective endocarditis (IE) often require valve replacement due to severe valve damage.
  • This study reviews surgical treatment experiences for pediatric IE, focusing on incidence, pathology, diagnosis, surgical strategies, and outcomes.

Purpose of the Study:

  • To review surgical treatment outcomes for children with infective endocarditis (IE) in China.
  • To analyze the incidence, pathological status, diagnosis, surgical strategies, and outcomes of pediatric IE.

Main Methods:

  • Retrospective analysis of 35 pediatric patients who underwent valve replacement surgery for IE between 1993 and 2013.
  • Preoperative transthoracic echocardiography (TTE) and intraoperative transesophageal echocardiography were performed on all patients.
  • Chart review and retrospective risk-hazard analysis were conducted.

Main Results:

  • Congenital heart lesions were present in 42.8% of patients; 5.7% had rheumatic heart valve disease, and 5.7% had prior heart surgery.
  • The mitral and aortic valves were most commonly affected (88.5%); one patient had triple or quadruple valve involvement.
  • Ten-year freedom from IE-related death and re-intervention was 94.2% and 91.6%, respectively.

Conclusions:

  • Pediatric IE surgery patients often present with advanced disease and embolic complications.
  • Valve replacement in pediatric IE, while not ideal, demonstrated optimal 5-year survival and freedom from re-operation rates.
  • Early recognition of IE clinical features is crucial for pediatric physicians to preserve native valves.
Abstract

Keywords:
Childreninfective endocarditis (IE)valve replacement

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