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Recurrent endocarditis on restrictive perimembranous septal defect causing aortic insufficiency
Houcine Horchani1,2,3, Khedija Soumer1,2,3, Salma Nsiri1,2,3
1Department of Cardiovascular Surgery, Abderrahmen Mami Pneumology and Phthisiology Hospital, Ariana, Tunisia.
Insights
Infective endocarditis (IE) in children, often linked to ventricular septal defects (VSD), poses a high risk of recurrence and complications. This case highlights severe aortic regurgitation after VSD repair, necessitating reoperation.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Infective endocarditis (IE) is rare in children but carries a high event rate.
- Ventricular septal defect (VSD) is a primary predisposing condition for pediatric IE.
- Long-term IE follow-up is challenging due to relapse and reintervention risks.
Observation:
- A child with a restrictive perimembranous VSD experienced recurrent IE.
- Severe aortic regurgitation developed after surgical closure of the VSD.
- The patient required reoperation due to IE complications.
Findings:
- Recurrent IE on a repaired VSD can lead to significant valve damage.
- Post-surgical aortic regurgitation is a potential complication of IE in VSD patients.
- Surgical intervention may be necessary for managing IE-induced aortic valve lesions.
Implications:
- This case underscores the importance of vigilant long-term monitoring for pediatric IE patients, especially those with congenital heart defects.
- Early recognition and management of complications like aortic regurgitation are crucial for favorable outcomes.
- Further research into preventative strategies and optimal management protocols for recurrent IE in children is warranted.
Abstract:
Infective endocarditis (IE) in children is a rare entity which presents a high rate of events during follow-up. Congenital heart disease, i particular ventricular septal defect (VSD), is the main predisposing condition to IE at those ages. The long-term risk of IE is of concern and whose follow-up can be complicated by a relapse of IE and reintervention. The endocarditis can affect the aortic valve (AV) and induce destructive lesions such as perforation of the valve making it leaky. We report an uncommon case of recurrent endocarditis on restrictive perimembranous VSD, and onset of severe aortic regurgitation after surgical closure, requiring a reoperation.
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