Infective endocarditis in congenital heart disease
- 20 July 2011
- journal article
- review article
- Published by Springer Science and Business Media LLC in European Journal of Pediatrics
- Vol. 170 (9), 1111-1127
- https://doi.org/10.1007/s00431-011-1520-8
Abstract
Congenital heart disease (CHD) has become the leading risk factor for pediatric infective endocarditis (IE) in developed countries after the decline of rheumatic heart disease. Advances in catheter- and surgery-based cardiac interventions have rendered almost all types of CHD amenable to complete correction or at least palliation. Patient survival has increased, and a new patient population, referred to as adult CHD (ACHD) patients, has emerged. Implanted prosthetic material paves the way for cardiovascular device-related infections, but studies on the management of CHD-associated IE in the era of cardiovascular devices are scarce. The types of heart malformation (unrepaired, repaired, palliated) substantially differ in their lifetime risks for IE. Streptococci and staphylococci are the predominant pathogens. Right-sided IE is more frequently seen in patients with CHD. Relevant comorbidity caused by cardiac and extracardiac episode-related complications is high. Transesophageal echocardiography is recommended for more precise visualization of vegetations, especially in complex type of CHD in ACHD patients. Antimicrobial therapy and surgical management of IE remain challenging, but outcome of CHD-associated IE from the neonate to the adult is better than in other forms of IE. Conclusion: Primary prevention of IE is vital and includes good dental health and skin hygiene; antibiotic prophylaxis is indicated only in high-risk patients undergoing oral mucosal procedures.Keywords
This publication has 126 references indexed in Scilit:
- Awareness of the risk of endocarditis associated with tattooing and body piercing among patients with congenital heart disease and paediatric cardiologists in the United KingdomArchives of Disease in Childhood, 2007
- Current patterns of infective endocarditis in congenital heart diseaseHeart, 2006
- Clinical Characteristics and Outcome of Aortic Endocarditis With Periannular Abscess in the International Collaboration on Endocarditis Merged DatabaseThe American Journal of Cardiology, 2005
- Clinical course and complications of infective endocarditis in patients growing up with congenital heart diseaseInternational Journal of Cardiology, 2005
- Infective endocarditis in children — incidence, pattern, diagnosis and management in a developing countryInternational Journal of Cardiology, 2001
- Early clinical experience with use of the ‘Amplatzer Septal Occluder’ device for atrial septal defectCardiology in the Young, 1998
- Pediatric infective endocarditis in the modern eraThe Journal of Pediatrics, 1993
- Infective endocarditis in infants and children during the past 10 years: A decade of changeAmerican Heart Journal, 1984
- A forty-year review of bacterial endocarditis in infancy and childhood.Circulation, 1975
- Incidence of Bacterial Endocarditis in Ventricular Septal DefectsCirculation, 1966