Clinico-pathological characteristics of infective endocarditis associated with congenital heart disease: an analysis of 74 cases in single center / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To assess the changing profile of infective endocarditis (IE) in patients with congenital heart disease (CHD) from 1998 to 2009 in our hospital.</p><p><b>METHODS</b>Clinical characteristics of IE patients with CHD underwent surgical treatment during 1998 - 2009 in our hospital were evaluated. The coincidence rate between clinical and pathological diagnosis were analyzed.</p><p><b>RESULTS</b>There were 74 IE cases associated with CHD during the 12 years, accounting for 33.6% of all patients with IE receiving surgery during this time period. Mean age was higher for patients treated in 2006 - 2009 than patients treated in 2002 - 2005 [(38.7 ± 14.6) years vs. (28.4 ± 12.8) years, P = 0.003].Bicuspid aortic valve (accounting for 52.2%) was the most frequent congenital heart disease and the age of these patients was younger than patients with other congenital heart diseases. IE in CHD affected the left heart structures in 83.8% (62/74) of all cases, 47 in aortic valve (75.8%). Blood cultures were performed in 29.7% of the patients (22/74) and the positive rate was 59.1% (13/22). Streptococci viridans were the most common causative organisms. Echocardiography was performed in all patients and 66.3% echocardiographic records were positive, IE was diagnosed in 53 patients (71.7%) before operation. The operative mortality was 2.7%.</p><p><b>CONCLUSION</b>Congenital heart disease, especially bicuspid aortic valve, is the most common underlying disease for IE. Combined analysis of clinical, echocardiographic and blood culture results are essential for increasing the diagnosis rate of IE.</p>