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Updated: Jul 5, 2025

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Surgery for paravalvular abscess in children.

Damien M Wu1,2,3, Igor E Konstantinov1,2,3,4, Michael Z L Zhu1,2,3

  • 1Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.

JTCVS Open
|January 11, 2024
PubMed
Summary

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Surgery for paravalvular abscess in children has high early mortality but good long-term survival for survivors. Reoperation is common, but rarely due to endocarditis recurrence.

Area of Science:

  • Pediatric Cardiac Surgery
  • Infectious Disease Cardiology
  • Congenital Heart Disease Surgery

Background:

  • Paravalvular abscesses are serious complications following cardiac surgery.
  • Prompt diagnosis and surgical intervention are crucial for managing these complex pediatric cases.

Purpose of the Study:

  • To evaluate the surgical outcomes and long-term survival of children diagnosed with paravalvular abscess.
  • To identify risk factors associated with mortality and reoperation in this pediatric population.

Main Methods:

  • Retrospective review of 30 pediatric patients who underwent surgery for paravalvular abscess between 1989 and 2020.
  • Analysis of surgical procedures, postoperative support, mortality, survival rates, and reoperation indications.
Keywords:
cardiac surgerychildreninfective endocarditisparavalvular abscess

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Main Results:

  • Aortic annulus abscesses were most common (76.7%). 15-year survival was 79.7%, with high early mortality (23.3%) often linked to ECMO support.
  • Preoperative shock and *Streptococcus pneumoniae* infection were associated with increased mortality.
  • Freedom from reoperation was 40.0% at 15 years, with central fibrous body reconstruction linked to reoperation.

Conclusions:

  • Pediatric paravalvular abscess surgery carries significant early mortality risk but offers good long-term survival for survivors.
  • Reoperation is frequent, but recurrence of endocarditis is uncommon; other factors drive reoperation needs.