Diagnosis And Therapy Of Infective Endocarditis Associated With Congenital Heart Disease In Children

Objective : Summarize the clinical characteristics,experience of diagnose and treatment in pediatric congenital heart disease(CHD)associated with infective endocarditis(IE).Choose the appropriate time of surgery,surgical methods,grasp the surgical indications to reduce mortality.Methods : Review clinical characteristics,diagnosis,treatment,the opportunity,method,principle of operation and outcome of CHD associated with IE in cardio-thoracic surgery of our hospital during March 2006 and April 2016.Results:In this study,28 patients of CHD associated with IE only received antimicrobial therapy in 15 patients during hospitalized,of which 5 patients improved and discharged,6 patients without improvement and require discharged,4 dead.During the follow-up,3 patients improved after surgical in other hospital.two dead after discharged from our hospital,the remaining 6 patients lost follow-up.13 patients received peration.operation were performed to eliminate the focus of infection thoroughly and reconstruct impaired intracardiac construction,and rescue the abnormal cardiac instructre.PDA ligate in 2 patients,PDA ligate with mitral valve replacement in 1 patient,CAA repair with tricuspid valvuloplasty in 1 patient,VSD repair with tricuspid valvuloplasty in 4 patient,VSD and ASD repair with tricuspid valvuloplasty in 2 patients,VSD and ASD repair with tricuspid polyester patch in 1 patient,ASD repair with PDA ligate in 1 patient,ASD repair with tricuspid valvuloplasty in 1 patient.One lost follow-up,others followed up 6 months to 9 years without recurrence.Conclusion : Only conservative therapy is ineffective in CHD associated with IE,but surgical treatment in time can get good results.It is very important to choose an appropriate time of operation,grasp the surgical indications and completely remove the neoplasm and repair the abnormal cardic instructre.