NDLI: Thirty-Year Incidence of Infective Endocarditis After Surgery for Congenital Heart Defect

Content Provider	JAMA Network
Author	Morris, Cynthia D. Reller, Mark D. Menashe, Victor D.
Copyright Year	1998
Abstract	Context.— The incidence of infective endocarditis after surgical repair of congenital heart defects is unknown. Objective.— To determine the long-term incidence of endocarditis after repair of any of 12 congenital heart defects in childhood. Design.— Population-based registry started in 1982. Setting.— State of Oregon. Participants.— All Oregon residents who underwent surgical repair for 1 of 12 major congenital defects at the age of 18 years or younger from 1958 to the present. Main Outcome Measure.— Diagnosis of infective endocarditis confirmed by hospital or autopsy records. Results.— Follow-up data were obtained from 88% of this cohort of 3860 individuals through 1993. At 25 years after surgery, the cumulative incidence of infective endocarditis was 1.3% for tetralogy of Fallot, 2.7% for isolated ventricular septal defect, 3.5% for coarctation of the aorta, 13.3% for valvular aortic stenosis, and 2.8% for primum atrial septal defect. In the cohorts with shorter follow-up, at 20 years after surgery the cumulative incidence was 4.0% for dextrotransposition of the great arteries; at 10 years, the cumulative incidence was 1.1% for complete atrioventricular septal defect, 5.3% for pulmonary atresia with an intact ventricular septum, and 6.4% for pulmonary atresia with ventricular septal defect. No children with secundum atrial septal defect, patent ductus arteriosus, or pulmonic stenosis have had infective endocarditis after surgery. Conclusion.— The continuing incidence of endocarditis after surgery for congenital heart defect, particularly valvular aortic stenosis, merits education about endocarditis prophylaxis for children and adults with repaired congenital heart defects.
Ending Page	603
Starting Page	599
Page Count	5
File Format	PDF HTM / HTML
ISSN	00987484
DOI	10.1001/jama.279.8.599
Issue Number	8
Journal	JAMA
Volume Number	279
Language	English
Publisher	American Medical Association
Publisher Date	1998-02-25
Access Restriction	Open
Subject Keyword	aortic valve stenosis endocarditis bacterial endocarditis follow-up operative surgical procedures surgery for congenital heart disease aortic coarctation pulmonary atresia congenital heart defects tetralogy of fallot ventricular septal defect patent foramen ovale transposition of great vessels pulmonary valve stenosis atrioventricular septal defect pulmonary artery stenosis endocarditis prophylaxis patent ductus arteriosus
Content Type	Text
Resource Type	Article
Subject	Medicine

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