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Articles

Title: Complications of infective endocarditis in children

Author:
Bożena Werner, Maria Wróblewska-Kałużewska
Type:
Case Reports
Language:
PL
Journal:
Polish Journal of Cardiology
Year:
2002
Volume:
4
Number:
3
Start page:
295
Final page:
299
ISSN:
1507-5540
Keywords:
infective endocarditis, complications, children
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Introduction: Complications of infective endocarditis in children are very rare. Aim: The aim of the study was to analyse complications of endocarditis and indications for surgical treatment. Material and methods: Among 34 children treated for infective endocarditis, 10 were found to have complications (6 girls and 4 boys aged from 7 months to 17 years). In 6 children native valve endocarditis was found, while in 4 the disease followed cardiosurgery. The diagnosis of complications and hemodynamic status of the patients were assessed by echocardiography with conventional and color Doppler imaging. In 2 children transesophageal approach was performed. Results: The following complications of endocarditis were recognized: perforations of atrio-ventricular valvular leaflets with severe valvular insufficiency in 3 children, including 2 with perforations of anterior mitral leaflet and 1 with perforation of tricuspid valve. Severe aortic insufficiency was found in 3 children including 1 with mycotic aneurysm of sinus ofValsalva. In 3 children the recurrence of ventricular septal defectwith significantshuntwas recognized. In one child with fungal endocarditis huge mobile masses extended into the rightand left ventricular outflow tracts causing systemie and celebral emboli. All children required surgical treatment. One child died before and one after surgery. In 8 patients good results of cardiosurgery were found. Conclusions: 1. In the course of infective endocarditis in children the following complications may occur: valvular perfo-rations, mycotic aneurysm, celebral emboli and recurrence of ventricular septal defect. 2. Echocardiography plays a major role in recognition of the complications and precise assessment of heart defects. 3. Complications of endocarditis in children may be life-threatening and require emergency surgical treatment.