HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Citak, M. Articles by Mavroudis, C. Search for Related Content PubMed PubMed Citation Articles by Citak, M. Articles by Mavroudis, C.

The Annals of Thoracic Surgery, Vol 54, 755-760, Copyright © 1992 by The Society of Thoracic Surgeons

ARTICLES

Surgical management of infective endocarditis in children

M Citak, A Rees and C Mavroudis
Department of Surgery, University of Louisville, Kentucky.

Infective endocarditis occurs infrequently in the general pediatric population, occurring mostly in patients with congenital heart disease. This study reviews our surgical experience with infective endocarditis based on a policy of aggressive intervention, conservative operative debridement, and creative reconstruction options using pericardium and prosthetic heart valves. From 1982 to 1989, 16 patients, 3 weeks to 16 years of age, underwent 19 intracardiac operations for infective endocarditis therapy at Kosair Children's Hospital. Eight (42%) were for resection of vegetations alone; an additional 11 operations (58%) involved more extensive debridements requiring either valve replacement or valvuloplasty using pericardium for exclusion of an abscess cavity, closure of a fistula, or for valve repair. Operative mortality was 25% (4 patients) and related to preoperative disease severity. There was one late death. Offending organisms included Staphylococcus species (31%), Haemophilus influenzae (13%), pneumococcus (5%), gram-negative organisms (13%), and Candida (13%); no organism grew on culture in 25%. We conclude that aggressive surgical exploration in patients with infective endocarditis is indicated and often requires resection of vegetations alone. More extensive procedures should preserve as much valvular tissue as possible. Pericardium is useful for reconstruction after debridement.

This article has been cited by other articles:

				K Niwa, M Nakazawa, S Tateno, M Yoshinaga, and M Terai Infective endocarditis in congenital heart disease: Japanese national collaboration study Heart, June 1, 2005; 91(6): 795 - 800. [Abstract] [Full Text] [PDF]

				P. Ferrieri, M. H. Gewitz, M. A. Gerber, J. W. Newburger, A. S. Dajani, S. T. Shulman, W. Wilson, A. F. Bolger, A. Bayer, M. E. Levison, et al. Unique Features of Infective Endocarditis in Childhood Pediatrics, May 1, 2002; 109(5): 931 - 943. [Full Text] [PDF]

				P. Ferrieri, M. H. Gewitz, M. A. Gerber, J. W. Newburger, A. S. Dajani, S. T. Shulman, W. Wilson, A. F. Bolger, A. Bayer, M. E. Levison, et al. Unique Features of Infective Endocarditis in Childhood Circulation, April 30, 2002; 105(17): 2115 - 2126. [Full Text] [PDF]

				U. Acikel, B. S. Ugurlu, O. Karabay, E. Silistreli, and O. Oto Retrograde cerebral perfusion with hypothermic circulatory arrest in a child Ann. Thorac. Surg., April 1, 2000; 69(4): 1243 - 1244. [Abstract] [Full Text] [PDF]

				K. Goh, H. Yamamoto, N. Tsuda, and T. Sasajima Konno procedure for infective endocarditis involving aortic valve in a small child Ann. Thorac. Surg., April 1, 2000; 69(4): 1264 - 1266. [Abstract] [Full Text] [PDF]

				C. Alexiou, S. M. Langley, and J. L. Monro Surgery for infective valve endocarditis in children Eur. J. Cardiothorac. Surg., December 1, 1999; 16(6): 653 - 659. [Abstract] [Full Text] [PDF]

				A. M. Aly, P. M. Simpson, and R. A. Humes The Role of Transthoracic Echocardiography in the Diagnosis of Infective Endocarditis in Children Arch Pediatr Adolesc Med, September 1, 1999; 153(9): 950 - 954. [Abstract] [Full Text] [PDF]

				M. W. Frank, C. Mavroudis, C. L. Backer, and A. P. Rocchini Repair of Mitral Valve and Subaortic Mycotic Aneurysm in a Child With Endocarditis Ann. Thorac. Surg., June 1, 1998; 65(6): 1788 - 1790. [Abstract] [Full Text] [PDF]

				F. Nomura, D. J. Penny, S. Menahem, A. Pawade, and T. R. Karl Surgical Intervention for Infective Endocarditis in Infancy and Childhood Ann. Thorac. Surg., July 1, 1995; 60(1): 90 - 95. [Abstract] [Full Text]

				M. C. K. Hosking, N. E. MacDonald, and G. Cornel Liposomal Amphotericin B for Postoperative Aspergillus fumigatus Endocarditis Ann. Thorac. Surg., April 1, 1995; 59(4): 1015 - 1017. [Abstract] [Full Text]