The following is the summary of “Surgical outcomes of infective endocarditis in pediatrics: Moving the needle to a contemporary, multidisciplinary approach,” published in the January 2023 issue of Thoracic and cardiovascular surgery by Carrillo, et al.
Although cases of infective endocarditis (IE) in children are relatively rare, when they do occur, they can have devastating effects on both quality of life and life expectancy. When CHD is present, treatment can become more challenging. The purpose of this research was to characterize and analyze the results for children who had surgery for IE. Consecutive patients younger than 20 years old with IE who underwent surgery between 2004 and 2020 were identified using a retrospective chart review.
The median age of the 94 patients diagnosed with IE was 16.7 years old, and 47 of them underwent surgery. The congenital cardiac disease affected 31 patients (65.95%). The brain was the most prevalent site (57.1%) for both vegetative and embolic phenomena, which affected 41 and 29 patients, respectively (87.23% and 61.7%). Embolising was more common in patients with native valve involvement (P<.001). The most frequent microorganism found was Staphylococcus spp. (49%). The most commonly impacted (31.9%) was the mitral valve. Valve replacement was the most prevalent surgery (37 patients, 78.7%), while 7 patients (14.9%) had multivalvar involvement. About 3 persons passed away during surgery (6.4%).
The typical patient spent 21 days in the hospital. Surgical delay in days (P<.001) and native valvar involvement (P=.05) were significant predictors of longer-than-expected hospital stays. It was shown that five individuals (10.6%) experienced recurrent IE after surgery. There was a 93.6% one-year survival rate and an 89.4% 5 survival rate. The surgical treatment of IE in children has an adequate success rate. Embolic complications are the primary cause of morbidity but not fatality. Both native valve involvement and the presence of Staphylococcus spp. pose substantial dangers.
Source: sciencedirect.com/science/article/abs/pii/S0022522322003890
