77Infective endocarditis in patients with congenital heart disease: Results of a nationwide study including 1494 endocarditis cases

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G P Diller ◽  
E Freisinger ◽  
L Bronstein ◽  
J Koeppe ◽  
J Gerss ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Relative Risk ◽  
Infective Endocarditis ◽  
Adverse Events ◽  
Congenital Heart ◽  
Surgical Intervention ◽  
High Morbidity ◽  
Heart Defect ◽  
Major Adverse Events

Abstract Background Infective endocarditis (IE) represents a major complication in patients with congenital heart disease (CHD) and is associated with high morbidity and mortality. The aim of this study was to analyse the frequency and outcome of IE in contemporary CHD patients based on all IE hospital admissions in Germany between 2011 and 2016. Methods Based on the German diagnosis related groups data of patients treated between 2011 and 2016, we identified all CHD patients with a diagnosis of IE. The data contains information on patient demographics, primary and secondary diagnoses, interventional or surgical procedures, duration of stay and outcome including mortality. The primary endpoint of the study was endocarditis-associated mortality as well as major adverse events (defined as death or myocardial infarction, stroke, pulmonary embolism, sepsis, resuscitation or intubation). Results Overall, 181,924 CHD patients were included in the analysis (55% male; 73% children, mean age 2.3 years; 27% adults, mean age 58.4 years; underlying heart defect of simple complexity 55%, moderate complexity 23% and complex heart defect 22%, respectively). During the study period 1494 cases were treated for IE corresponding to 0.82% of all inpatient treatment cases in CHD patients. Mortality rate was 6.6% (95% CI: 5.0–7.6%) with a major adverse events rate of 44.6% (95% CI: 41.3–48.2%). In total, 682 IE patients (45.7% CI: 42.3%-49–2%) required a surgical intervention. The relative risk of dying due to endocarditis in CHD patients was significantly lower compared to older IE patients without CHD (relative risk 0.39; 95% CI: 0.32–0.47). Conclusions Infective endocarditis accounts for a minority of CHD related hospitalizations but remains a deadly disease with a high proportion of patients requiring surgical intervention. In addition, major adverse events are common in this setting, with almost half of the IE population presenting with a major adverse event. Due to different demographic and comorbidity spectrum encountered in CHD patients, these younger patients tend to have significantly better survival prospects compared to non-CHD IE patients in the current era.

scholarly journals Frequency, Mortality, and Predictors of Adverse Outcomes for Endocarditis in Patients with Congenital Heart Disease: Results of a Nationwide Analysis Including 2512 Endocarditis Cases

2021 ◽  
Vol 10 (21) ◽  
pp. 5071
Author(s):  
Maarja Maser ◽  
Eva Freisinger ◽  
Leo Bronstein ◽  
Jeanette Köppe ◽  
Stefan Orwat ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Adverse Events ◽  
Congenital Heart ◽  
Hospital Admissions ◽  
Heart Defects ◽  
Adverse Outcomes ◽  
High Morbidity ◽  
Co Morbidity ◽  
Major Adverse Events

Background: Infective endocarditis (IE) represents a major complication in patients with congenital heart disease (CHD) and is associated with high morbidity and mortality. The aim of this study was to analyse the frequency and outcome of IE in contemporary CHD patients based on all IE hospital admissions in Germany over a 10-year period. Methods: Based on data of all hospital admissions in Germany from 2009 to 2018, we identified all CHD cases with a diagnosis of IE. The data contained information on patient demographics, diagnoses, surgical procedures, and mortality. The primary endpoint of the study was endocarditis-associated mortality as well as major adverse events (defined as death or myocardial infarction, stroke, pulmonary embolism, sepsis, renal dialysis, resuscitation, or intubation). Results: Overall, 309,245 CHD inpatient cases were included in the analysis (underlying heart defects of simple complexity 55%, moderate complexity 23%, and complex heart defects 22%, respectively). Of those, 2512 (0.8% of all inpatient cases) were treated for IE. The mortality rate of IE inpatient cases was 6% with a major adverse events rate of 46%, and 41.5% of cases required surgical intervention. The overall IE associated mortality was lower in adult CHD cases compared to the 153,242 in adult IE cases without CHD (7.1% vs. 16.1%, p < 0.001). After adjustments using multivariable logistic regression analysis, the presence or complexity of CHD was not associated with the outcomes. Meanwhile, age, male sex, and co-morbidities emerged as significant predictors of adverse outcomes. Conclusions: IE accounts for a minority of CHD related hospitalizations but remains a deadly disease, and major adverse events are common in this setting. Due to different demographic and co-morbidity spectrums, adult CHD patients tend to have better survival prospects when compared to non-CHD IE patients. Acquired co-morbidities emerged as the main predictors of adverse outcomes.

scholarly journals Characteristics and safety of interventions and procedures performed during catheterisation of patients with congenital heart disease: early report from the national cardiovascular data registry

2015 ◽  
Vol 26 (6) ◽  
pp. 1202-1212 ◽  
Author(s):  
Ralf Holzer ◽  
Robert Beekman ◽  
Lee Benson ◽  
Lisa Bergersen ◽  
Natalie Jayaram ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Data Collection ◽  
Adverse Events ◽  
Congenital Heart ◽  
Early Report ◽  
Time Frame ◽  
Adult Congenital ◽  
Data Elements ◽  
Major Adverse Events

AbstractObjectivesThe objective of this study was to report procedural characteristics and adverse events on the data collected in the IMproving Paediatric and Adult Congenital Treatment registry.BackgroundThe IMproving Paediatric and Adult Congenital Treatment– registry is a catheterisation registry focussed on paediatric and adult patients with congenital heart disease who are undergoing diagnostic catheterisations and catheter-based interventions. This study reports procedural characteristics and adverse events of patients who have undergone selected catheterisation procedures from January, 2011 to June, 2013.MethodsDemographic, clinical, procedural, and institutional data elements were collected at participating centres and entered via either a web-based platform or software provided by the American College of Cardiology-certified vendors, and were collected in a secure, centralised database. For the purpose of this study, procedures that were not classified as one of the ‘core’ IMproving Paediatric and Adult Congenital Treatment procedures originally chosen for additional data collection were identified and selected for further data analysis.ResultsDuring the time frame of data collection, a total of 8021 cases were classified as other procedures and/or multiple procedures. The most commonly performed case types – isolated or in combination with other procedures – were right ventricular biopsy in 3433 (42.8%), conduit/MPA interventions in 979 (12.3%), and systemic pulmonary artery collateral occlusion in 601 (7.5%). For the whole cohort, adverse events of any severity occurred in 957 (12.0%) cases, whereas major adverse events occurred in 113 (1.4%) cases; six patients (0.1%) died in the catheterisation laboratory.ConclusionsThe IMproving Paediatric and Adult Congenital Treatment registry has provided important data on the frequency and spectrum of cardiac catheterisation procedures performed in the present era. For many procedures, more data and work are needed to identify more subtle differences between case categories, especially as it relates to the incidence of major adverse events, and to further develop a risk-adjustment methodology to allow equitable comparisons among institutions.

scholarly journals Infective endocarditis in adults with congenital heart disease: still a potentially lethal disease

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P2135-P2135
Author(s):  
O. Tutarel ◽  
R. Schiff ◽  
R. Alonso-Gonzalez ◽  
A. Kempny ◽  
A. Uebing ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Congenital Heart

Nineteen Years of Adult Congenital Heart Surgery in a Single Center

2017 ◽  
Vol 8 (2) ◽  
pp. 182-188
Author(s):  
Madurra Perinpanayagam ◽  
Signe H. Larsen ◽  
Kristian Emmertsen ◽  
Marianne B. Møller ◽  
Vibeke E. Hjortdal
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Postoperative Complications ◽  
Adverse Events ◽  
Congenital Heart ◽  
Postoperative Bleeding ◽  
Registration System ◽  
Growing Population

Background: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort. Methods: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System. Results: Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%). Conclusion: Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.

Infective endocarditis with congenital heart disease

2006 ◽  
Vol 54 (7) ◽  
pp. 297-300 ◽  
Author(s):  
Yasuyuki Suzuki ◽  
Kazuyuki Daitoku ◽  
Masahito Minakawa ◽  
Kozo Fukui ◽  
Ikuo Fukuda
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Congenital Heart

First Case of Human Infection Caused by Pasteurella gallinarum Causing Infective Endocarditis in an Adolescent 10 Years After Surgical Correction for Truncus Arteriosus

PEDIATRICS ◽  
1995 ◽  
Vol 95 (6) ◽  
pp. 944-948
Author(s):  
Mohammad Al Fadel Saleh ◽  
Mohammad S. Al-Madan ◽  
Hashim H. Erwa ◽  
Ivy Defonseka ◽  
Saira Z. Sohel ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Congenital Heart ◽  
Human Infection ◽  
The Body ◽  
Surgical Correction ◽  
Truncus Arteriosus ◽  
Causative Organism ◽  
First Case

Objective. To report the first case of human infection (infective endocarditis [IEI]) caused by Pasteurella gallinarum and to review the literature regarding IE caused by the genus Pasteurella. Setting. University hospital based. Patient. An adolescent boy who underwent successful correction for truncus arteriosus 10 years before the present illness. Results. Persistent fever, pallor, and a palpable spleen suggested IE clinically. Echocardiography documented vegetation in the conduit that was used for surgical correction. Blood cultures grew P. gallinarum and confirmed its role as the causative organism for IE in the patient. Conclusion. This case illustrates that IE may develop in a child with congenital heart disease several years after surgical intervention using material that is foreign to the body (conduit), and that such a complication may involve unusual pathogens. These observations emphasize the need for careful long-term follow-up of children with congenital heart disease even after successful surgical correction.

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