Clinical analysis, surgical treatment and mortality in patients with infective endocarditis and associated adult congenital heart disease

Abstract

Aim: To analyze the clinical characteristics, treatment, mortality, and prognosis of patients with infective
endocarditis and associated adult congenital heart disease who attended the Hospital Interzonal Especializado de Agudos y Crónicos (HIEA y C) of the city of La Plata between the years 2010 and 2022. Materials and Methods: Observational, descriptive, cross-sectional study that included the population registered in the "Infectious Endocarditis" database compiled by cardiology residents
of the HIEA y C San Juan de Dios of La Plata. Those with associated congenital heart disease were selected as the study sample for specific analysis. There were 141 patients in total, of which 35 (24.82%) had an associated congenital heart disease. Clinical and microbiological data, need for
surgical treatment, complications and in-hospital mortality were considered. Outcomes: Of the 35 patients, 85.71% were male, the mean age was 49.47 years; 85.71% presented with ACHD associated with bicuspid aortic valve (BAV). The most frequent presentations were fever and weight loss. The most recorded complication was the presence of embolisms, among which the majority were in limbs. The infectious agent was identified in 91.43% people,
with Staphylococcus aureus being the most prevalent. Valve replacement surgery was performed in 77.14% of patients. In-hospital mortality was 17.14%. Conclusion: Infective endocarditis is a frequent complication of congenital heart disease in adults. A high degree of clinical suspicion should be maintained, mainly in the presence of persistent
fever in a patient with this heart disease in the absence of another apparent cause.