Related Experiment Video

Updated: Oct 1, 2025

Implantation of Total Artificial Heart in Congenital Heart Disease
07:27

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

24.8K

Infective endocarditis in a cohort of adult CHD patients

Tânia B Mano1, Isabel Cardoso1, Pedro O Costa2

  • 1Cardiology Department, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

Cardiology in the Young
|March 4, 2022
PubMed

Insights

Adults with congenital heart disease (CHD) have a high risk of infective endocarditis, often requiring surgery and carrying substantial mortality. Current guidelines may not adequately cover prophylaxis for conditions like ventricular septal defects and bicuspid aortic valves.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Congenital heart disease (CHD) increases infective endocarditis (IE) risk due to prosthetic materials and residual lesions.
  • Data on lesion-specific and mortality risks in adult CHD patients with IE are limited.
  • This study analyzed the clinical course and mortality of IE in a cohort of adult CHD patients.

Purpose of the Study:

  • To analyze the clinical course and mortality of infective endocarditis (IE) in adult patients with congenital heart disease (CHD).
  • To identify predictors of surgical treatment and mortality in this population.
  • To evaluate the current IE prophylaxis guidelines in light of observed IE frequencies in specific CHD types.

Main Methods:

  • Retrospective analysis of proven and probable IE cases (Duke's criteria) in an adult CHD clinic (1970-2021).
  • Analysis of epidemiological, clinical, and imaging data.
  • Regression analysis to assess predictors of surgical treatment and mortality.

Main Results:

  • 96 patients experienced 105 IE episodes over a mean follow-up of 15.8 years; half had prior cardiac surgery.
  • Ventricular septal defect, bicuspid aortic valve, Tetralogy of Fallot, and pulmonary atresia were common diagnoses.
  • In-hospital mortality was 10.5%, associated with heart failure and non-surgical management.

Conclusions:

  • Infective endocarditis is more common in adult CHD patients with ventricular septal defects and bicuspid aortic valves than current guidelines suggest for prophylaxis.
  • Surgical intervention is frequently necessary for IE in this cohort.
  • Substantial mortality underscores the need for improved IE prevention strategies in adults with CHD.
Abstract

Keywords:
Infective endocarditisadult CHDbicuspid aortic valvesventricular septal defect

More Related Videos

An In Vitro Model of a Parallel-Plate Perfusion System to Study Bacterial Adherence to Graft Tissues07:50

An In Vitro Model of a Parallel-Plate Perfusion System to Study Bacterial Adherence to Graft Tissues

Published on: January 7, 2019

7.0K
Isolation of Endocardial and Coronary Endothelial Cells from the Ventricular Free Wall of the Rat Heart08:22

Isolation of Endocardial and Coronary Endothelial Cells from the Ventricular Free Wall of the Rat Heart

Published on: April 15, 2020

18.7K

Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
47
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
35
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
32
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
61
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
69
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
96