Current patterns of infective endocarditis in congenital heart disease. Issue 10 (3rd July 2006)

• Record Type: Journal Article
• Authors: Di Filippo, S; Delahaye, F; Semiond, B; Celard, M; Henaine, R; Ninet, J; Sassolas, F; Bozio, A
• Is Part Of: Heart. Volume 92:Issue 10(2006)
• Page Start: 1490
• Page End: 1495
• Publication Date: 2006-07-03
• Subjects: CHD, congenital heart disease -- HACEK, Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens and Kingella kingae -- IE, infective endocarditis -- PCR, polymerase chain reaction -- VSD, ventricular septal defect; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2005.085332
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To assess the changing profile of infective endocarditis in patients with congenital heart disease. Methods: All cases diagnosed from 1966 to 2001 (revised Duke criteria) were retrospectively reviewed and categorised in periods I (< 1990) and II (⩾ 1990). Results: 153 episodes occurred, 81 in period I and 72 in period II. Mean age of affected patients was higher in period II. Non-operated ventricular septal defect, Rastelli correction and palliated cyanotic heart disease increased. Infective endocarditis in corrective surgery changed to patients with prosthetic material. Post-surgical cases decreased. Dental problems were the leading cause (period I 20% v II 33% of cases) with a large variety of pathological organisms (multiple species of Streptococcus ). Cutaneous causative infections increased (5% to 17%) with different species of Staphylococcus . Negative blood cultures lessened (20% to 7%, p = 0.03). Streptococci were the most common causative organisms in both periods. Severe heart failure and cardiac complications lessened (20% to 4% and 31% to 18% during periods I and II, respectively). Early surgery was more frequent in period II (32% v 18.5%, p = 0.02). One- and 10-year survival was 91% v 97% in period I and 89% v 97% in period II, respectively (NS). Conclusion: Current targets include complex cyanotic disease, congenital heart disease corrected with prosthetic material and small ventricular septal defect. Postoperative cases lessened; dental and cutaneous causes increased. Survival was unchanged. Prophylactic measures targeted at dental and cutaneous sources should be emphasised.