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Operative treatment for tricuspid valve endocarditis in a premature neonate

Gitanjali Indramohan1, Sheba John2, Christopher E Greenleaf3

  • 1Division of Pediatric Critical Care, Department of Pediatrics, University of Texas McGovern Medical School at Houston, Houston, Texas.

Proceedings (Baylor University. Medical Center)
|March 8, 2021
PubMed

Insights

Infective endocarditis in critically ill children can be serious. Surgical removal of valve vegetation and antibiotics successfully treated a preterm infant with this condition.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Neonatal Medicine

Background:

  • Infective endocarditis poses significant risks in hospitalized patients, particularly neonates with indwelling catheters.
  • Critically ill children with indwelling devices face an increased risk of developing infective endocarditis.
  • Surgical intervention is sometimes necessary for valvar dysfunction and infection burden in endocarditis.

Observation:

  • A preterm infant presented with refractory infective endocarditis and right heart failure.
  • The infant had a tricuspid valve vegetation, suspected to be associated with an indwelling umbilical venous catheter.
  • This case highlights a rare but severe complication in a vulnerable neonatal population.

Findings:

  • Successful treatment involved surgical resection of the tricuspid valve vegetation.
  • Tricuspid valve repair was performed concurrently with vegetation removal.
  • A subsequent 6-week course of antibiotics led to the resolution of infective endocarditis.

Implications:

  • This case demonstrates the efficacy of surgical management combined with antibiotics for refractory infective endocarditis in neonates.
  • Early recognition and intervention are crucial for improving outcomes in infants with catheter-related bloodstream infections and endocarditis.
  • Findings underscore the importance of vigilance for cardiac complications in neonates with indwelling catheters.

Keywords:
Infective endocarditisneonatessurgical managementtricuspid valve

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