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Late Bacterial Endocarditis in an Intravenous Drug User With an Amplatzer Septal Occluder

Michael S La Sala1, Hajir Zohourian2, Joseph McKeown3

  • 1College of Osteopathic Medicine, Nova Southeastern University, Davie, Florida 33328.

Texas Heart Institute Journal
|January 20, 2021
PubMed

Insights

Late infective endocarditis, a rare complication of the Amplatzer Septal Occluder, occurred 14 years post-implantation in an intravenous drug user. Surgical intervention led to recovery, highlighting the need for ongoing surveillance in high-risk patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Infective endocarditis in cardiac devices presents unique challenges, particularly late-onset cases.
  • The Amplatzer Septal Occluder is commonly used for atrial septal defect closure, but late endocarditis is rare.

Observation:

  • A case of late bacterial endocarditis in an Amplatzer Septal Occluder is presented.
  • The patient was an intravenous drug user with methicillin-sensitive Staphylococcus aureus bacteremia, nearly 14 years after device implantation.

Findings:

  • Successful treatment involved surgical excision and débridement of the vegetative mass.
  • This surgical approach may be the first reported for this specific complication.

Implications:

  • This case underscores the importance of considering late endocarditis in patients with septal occluder devices.
  • Routine screening for high-risk individuals with these devices is recommended to detect early signs of infection.

Keywords:
Cardiac surgical proceduresendocarditis, bacterial/complications/diagnosis/etiologyheart septal defects, atrial/pathologyprostheses and implantsprosthesis-related infections/diagnosis/surgeryrisk factorsseptal occluder devices/adverse effectstreatment outcome

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