This article is more than 5 years old. Information may no longer be current.
Infective endocarditis rate high in adults with congenital ventricular septal defect
Click Here to Manage Email Alerts
Adults with a small congenital ventricular septal defect have a greatly increased risk for infective endocarditis, but there appears to be little effect on mortality, according to recent findings.
The researchers analyzed 779 patients (mean age, 39 years; 50% men) with a ventricular septal defect from the Swedish SWEDCON registry; 531 had small shunts that remained open, whereas 248 had their ventricular septal defect closed. The researchers compared that cohort with the National Patient Register identifying adults hospitalized for infective endocarditis during a 10-year period.
According to the researchers, 16 patients (2%; six men; mean age at hospitalization, 46 years) were hospitalized for infective endocarditis. Thirteen had a shunt that remained open, and in no case did it need to be closed.
Three had their shunt previously closed and all had previous aortic valve disease, with two of them having undergone aortic valve replacement at least 3 months before contracting infective endocarditis, the researchers wrote.
All three of those with a previously closed shunt underwent aortic valve reintervention, and one died from complications, whereas none of the 13 patients with an open shunt and infective endocarditis died, they wrote.
For the overall cohort, the incidence of infective endocarditis was 2.3 per 1,000 person-years (95% CI, 1.3-3.7). For those with an isolated ventricular septal defect included in the registry before their infective endocarditis, the incidence was 1.7 per 1,000 person-years (95% CI, 0.7-3.3). For all patients with isolated ventricular septal defect, the incidence was 2.7 per 1,000 person-years (95% CI, 1.4-4.7). The incidence rates were 20 to 30 times those seen in the general population, and the disparity might become greater with age, according to the researchers.
No patients with a closed ventricular septal defect had infective endocarditis, they wrote.
“Health care providers should be aware that this seemingly simple heart lesion is associated with a high risk [for infective endocarditis],” the researchers wrote. – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts