ABSTRACT
Since their introduction, percutaneous techniques have been replacing conventional surgery as a first-line treatment for septal defects. Amplatzer devices were the first to be approved by the Food and Drug Administration, and their placement has become a standard procedure in pediatric cardiology. Bacterial endocarditis of intracardiac devices such as the Amplatzer septal occluder is very infrequent. We report a case of bacterial endocarditis in a pediatric patient with an Amplatzer device, who developed an infectious endocarditis six years after its placement and received conservative management with intravenous antibiotics, with satisfactory evolution.
Desde su aparición, las técnicas percutáneas han ido sustituyendo la cirugía convencional como tratamiento de primera línea en los defectos septales interauriculares. Los dispositivos Amplatzer fueron los primeros aprobados por la Food and Drug Administration, y su colocación se ha convertido en un procedimiento habitual en cardiología pediátrica. La aparición de endocarditis bacteriana sobre este tipo de dispositivos es muy infrecuente. Se presenta el caso de una endocarditis bacteriana en un paciente pediátrico portador de un dispositivo Amplatzer, que se manejó de forma conservadora con antibioterapia intravenosa, con evolución satisfactoria.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Endocarditis, Bacterial/drug therapy , Septal Occluder Device/microbiology , Child , Conservative Treatment/methods , Endocarditis, Bacterial/etiology , Humans , Male , Septal Occluder Device/adverse effects , Treatment OutcomeABSTRACT
An 18-year-old woman presented to our institution with fever, bilateral flank pain, headache and photophobia. She had a previous atrial septal defect (ASD) closure device inserted at the age of 9 years. Blood cultures on admission were positive for Corynebacterium diphtheriae, and transoesophageal echocardiogram (TOE) revealed an echodensity associated with the ASD closure device, most consistent with a vegetation. She was treated for infective endocarditis with 6 weeks of intravenous benzylpenicillin, and follow-up TOE showed resolution of the echodensity. To our knowledge, no cases of C. diphtheriaeendocarditis of an ASD closure device have previously been reported.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Corynebacterium diphtheriae/isolation & purification , Endocarditis/diagnosis , Heart Septal Defects, Atrial/surgery , Penicillin G/administration & dosage , Prosthesis-Related Infections/microbiology , Septal Occluder Device/microbiology , Adolescent , Echocardiography, Transesophageal , Endocarditis/drug therapy , Endocarditis/physiopathology , Female , Fever/microbiology , Flank Pain/microbiology , Humans , Infusions, Intravenous , Photophobia/microbiology , Prosthesis-Related Infections/drug therapy , Septal Occluder Device/adverse effects , Time Factors , Treatment OutcomeSubject(s)
Abscess/diagnostic imaging , Endocarditis, Bacterial/diagnostic imaging , Prosthesis-Related Infections/diagnostic imaging , Septal Occluder Device/adverse effects , Abscess/etiology , Abscess/surgery , Adult , Endocarditis, Bacterial/etiology , Endocarditis, Bacterial/surgery , Heart Septal Defects, Atrial/diagnostic imaging , Heart Septal Defects, Atrial/surgery , Humans , Male , Prosthesis-Related Infections/etiology , Prosthesis-Related Infections/surgery , Septal Occluder Device/microbiology , Time Factors , UltrasonographyABSTRACT
The role of transcatheter closure of a patent foramen ovale for cryptogenic stroke remains controversial. The most common complications include atrial arrhythmia and bleeding. Infectious complications are exceedingly rare. We describe a 37-year-old man with a history of transient ischemic attacks and a patent foramen ovale who underwent transcatheter closure, complicated by subacute endocarditis of the completely endothelialized device 2 years after placement.
