Korean Circ J.  2006 Apr;36(4):318-323. 10.4070/kcj.2006.36.4.318.

Infective Endocarditis in Adolescents and Adults with Congenital Heart Disease

• Kim SH
• Huh J
• Kang IS
• Lee HJ
• Yang JH
• Jun TG
• Park PW

• KMID: 1859060
• DOI: http://doi.org/10.4070/kcj.2006.36.4.318

Abstract

BACKGROUND AND OBJECTIVES: The development of new antibiotics and the advances in cardiac surgery has increased the number of patients with congenital heart disease (CHD) who grow into adulthood, and infective endocarditis (IE) has become one of the important complications. The aim of this study was to analyze the clinical findings of IE that occurred in adolescents and adults suffering with CHD.
SUBJECTS AND METHODS
In a retrospective case study, the medical records of 44 patients diagnosed as having IE were reviewed. The Duke criteria were used as the diagnostic criteria of IE.
RESULTS
Between October 1994 and December 2003, 44 patients and 49 cases were treated for IE with CHD in Samsung Medical Center. Their mean age was 45 years (median age: 44 years, range: 12-81 years) Ventricular septal defect (VSD) was the most common underlying cardiac disease (38.8%). In 18 of 49 cases (36.7%) CHD was diagnosed for the first time during the treatment of IE. 13 of the 31 patients with known CHD had not been seen on regular medical follow-ups. The common predisposing factors were dental procedures and acupuncture. The most common pathogens were Streptococcus viridans and Staphylococcus aureus. Valvular replacement was performed in 11 of the 19 VSD patients. Pulmonary complications developed in 12 (24.5%) and neurological complications developed in 10 (20.4%). The overall mortality was 2%.
CONCLUSION
IE in adult CHD has become an important complication that infrequently accompanies a serious problem like severe valvular destruction or neurological complications. Proper management of CHD should be done early and educating the patient on the proper self-care for IE should be continued throughout life.

Keyword

Endocarditis; bacterial; Heart defects; congenital; Adult; Heart septal defects; ventricular

MeSH Terms

Acupuncture
Adolescent*
Adult*
Anti-Bacterial Agents
Causality
Endocarditis*
Follow-Up Studies
Heart Defects, Congenital*
Heart Diseases
Heart Septal Defects
Heart Septal Defects, Ventricular
Humans
Medical Records
Mortality
Retrospective Studies
Self Care
Staphylococcus aureus
Thoracic Surgery
Viridans Streptococci
Anti-Bacterial Agents