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Aortic root replacement for complicated bacterial endocarditis in an infant.

M J Perelman¹, J Sugimoto, R A Arcilla

¹Department of Surgery, University of Chicago, IL.

Journal of Pediatric Surgery

|November 1, 1989

Summary

A 10-week-old infant with severe streptococcal aortic valve endocarditis and complications underwent successful aortic valve and root replacement using an aortic homograft. This represents the youngest patient to receive this treatment for bacterial endocarditis and annular abscess.

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Area of Science:

Cardiology
Pediatric Surgery
Infectious Diseases

Background:

Bacterial endocarditis in infants presents significant challenges.
Aortic valve endocarditis can lead to severe complications like heart failure and pseudoaneurysms.

Observation:

A 10-week-old female infant presented with streptococcal aortic valve endocarditis.
The condition was refractory to medical management and complicated by aortic insufficiency, congestive heart failure, annular abscess, and a large periaortic pseudoaneurysm.

Findings:

The infant underwent successful aortic valve and root replacement with coronary artery reimplantation using an aortic valve homograft (allograft).
This surgical intervention resolved the endocarditis and associated complications.

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Implications:

This case highlights the feasibility and success of aortic homograft use in extremely young patients with complex bacterial endocarditis.
It establishes a new precedent for the youngest patient treated with an aortic homograft for this condition and associated annular abscess.
This approach may offer a viable therapeutic option for complex pediatric endocarditis cases.