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Outcomes of surgery for infective endocarditis in children: A 30-year experience
| Content Provider | Scilit |
|---|---|
| Author | D'Udekem, Yves Khoo, Brandon Buratto, Edward Fricke, Tyson A. Gelbart, Ben Brizard, Christian P. Brink, Johann Konstantinov, Igor E. |
| Copyright Year | 2019 |
| Description | Journal: Journal of Thoracic and Cardiovascular Surgery Infective endocarditis (IE) is rare in children. Limited data have been reported on long-term outcomes of children who undergo surgery for IE. Data were retrospectively obtained from medical records for all children who underwent surgery for IE. Between 1987 and 2017, 138 children with IE required surgery (mean age 8.3±6.5 years). The majority (80.4%, 111/138) of children had underlying cardiac structural anomalies. Prior heart surgery was performed in 50.7% (70/138) of patients, including 19.6% (27/138) who had valve replacement. Operative mortality was 5.8% (8/138). Mean follow-up time was 9.7±7.6 years. Long-term survival at 5 and 25 years was 91.5% (95% CI: 85.1–95.2%) and 79.1% (95% CI: 66.3–87.5%), respectively. Risk factors associated with death were: age (HR=0.88, p=0.015), prosthetic valve IE (HR=3.86, p=0.02), coagulase negative Staphylococci (HR=4.52, p=0.015), increased duration of pre-operative antibiotic therapy (HR=1.02, p=0.009), shock (HR=3.68, p=0.028), and aortic valve replacement (HR=3.22, p=0.044). In patients with left-sided IE, risk factors independently associated with death were: heart failure (HR=18.8, p=0.025) and vegetation size adjusted to body surface area (HR=1.06, p=0.008). Freedom from recurrent endocarditis was 94.7% (95% CI: 87.7 – 97.8%) at 25 years. Children undergoing surgery for IE had good long-term survival and recurrence of IE was uncommon. Surgery during the active phase of endocarditis did not increase risk of mortality or reoperation. In patients with left-sided IE, vegetation size adjusted for patient body surface area was identified as a risk factor for death, and a useful indicator of prognosis. |
| Related Links | http://www.jtcvs.org/article/S002252231931298X/pdf |
| Ending Page | 1409 |
| Page Count | 11 |
| Starting Page | 1399 |
| ISSN | 00225223 |
| e-ISSN | 1097685X |
| DOI | 10.1016/j.jtcvs.2019.06.024 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Issue Number | 5 |
| Volume Number | 158 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2019-06-20 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Thoracic and Cardiovascular Surgery Cardiology and Cardiovascular Diseases Infective Endocarditis Valve Replacement |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine |
