Surgical Atrial Septal Patch Endocarditis in a Patient with a Complete Corrected Atrioventricular Canal Defect: A Case Report and Review of the Literature

Infective endocarditis (IE) is common in patients with corrected congenital heart disease (CHD) with a residual lesion, but is rarely found on surgical patches used to close atrial septal defects (ASDs). This is also reflected in the current guidelines that do not recommend antibiotic therapy for pa...

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Bibliographic Details
Published in:Diagnostics (Basel) 2023-02, Vol.13 (5), p.856
Main Authors: Serban, Adela, Achim, Alexandru, Gavan, Dana Elena, Tomoaia, Raluca, Molnar, Adrian, Suceveanu, Mihai, Axente, Dan Damian, Mot, Stefan, Dadarlat-Pop, Alexandra
Format: Article
Language:English
Subjects:
Abdomen
Abscesses
Antibiotics
Atrial septal defects
atrioventricular canal defect
Care and treatment
Case Report
Case reports
Causes of
congenital heart disease
Defects
Diagnosis
Dyspnea
Endocarditis
Fever
Fistula
Heart
Infections
infectious endocarditis
Infective endocarditis
Medical imaging
Patients
Prostheses
Surgery
surgical atrial patch
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Summary:Infective endocarditis (IE) is common in patients with corrected congenital heart disease (CHD) with a residual lesion, but is rarely found on surgical patches used to close atrial septal defects (ASDs). This is also reflected in the current guidelines that do not recommend antibiotic therapy for patients with a repaired ASD with no residual shunt six months after closure (percutaneous or surgical). However, the situation could be different in the case of mitral valve endocarditis, which causes leaflet disruption with severe mitral insufficiency and could seed the surgical patch. We present herein a 40-year-old male patient with a past medical history of a complete surgically corrected atrioventricular canal defect performed in childhood who presented with fever, dyspnea and severe abdominal pain. Transthoracic and transesophageal echocardiography (TTE and TEE) revealed vegetation at the level of the mitral valve and the interatrial septum. The CT scan confirmed ASD patch endocarditis and multiple septic emboli, guiding the therapeutic management. An accurate evaluation of cardiac structures should be mandatory when a systemic infection is detected in CHD patients, even if the defects were surgically corrected, because the detection and eradication of such infectious foci as well as a surgical reintervention are particularly difficult to achieve in this subpopulation.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics13050856