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Nichay N.R.
Meshalkin National Medical Research Center;
Novosibirsk State Medical University
Bogachev-Prokofiev A.V.
Meshalkin National Medical Research Center
Infective endocarditis in pediatric patients with pulmonary graft
Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(2): 139‑151
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To cite this article:
Nichay NR, Gorbatykh YuN, Voitov AV, et al. . Infective endocarditis in pediatric patients with pulmonary graft. Russian Journal of Cardiology and Cardiovascular Surgery.
2024;17(2):139‑151. (In Russ.)
https://doi.org/10.17116/kardio202417021139
To assess the risk of infective endocarditis (IE) in pediatric patients after implantation of different pulmonary conduits.
There were 403 pediatric patients aged 0—18 years who underwent implantation of pulmonary valved conduit between 2000 and 2016.
A total of 497 conduits were implanted including glutaraldehyde (GA)-treated bovine jugular vein (contegra) (n=181, 36.4%); GA-treated xenopericardial conduit (BioLAB) (n=84, 16.9%); diepoxyde (DE)-treated xenopericardial conduit with porcine aortic root (AB-composite) (n=65, 13.1%); DE-treated xenopericardial conduit (Pilon) (n=32, 6.4%) and cryopreserved pulmonary homograft (n=135, 27.2%). Primary implantation was made in 385 cases (77.5%), conduit reimplantation — in 112 cases (22.5%). Median follow-up was 6.75 years (IQR 4.0—9.3 years). One or more delayed re-interventions were carried out in 202 cases. Of these, 190 conduits were replaced due to dysfunction. IE was diagnosed in 26 (5.2%) patients in 2 days — 14 years after procedure (7 months; IQR 0.5 months — 4 years): Contegra — 2.8%, BioLAB — 7.1%, AB-composite — 6.2%, Pilon — 9.4%, Homograft — 5.9%. Five-year and ten-year freedom from IE was 94% and 92%, respectively. Twelve (46.2%) patients underwent removal of infected graft. In other cases (n=14, 53.8%), IE was treated with antibiotics. IE-related mortality was 26.9% (n=7). Risk of IE did not depend on the type of conduit (RR 0.82; 95% CI 0.58—1.16; p=0.257).
Conduit-related IE is still associated with high mortality. All types of available conduits are predisposed to infection without any difference among them.
Keywords:
Authors:
Nichay N.R.
Meshalkin National Medical Research Center;
Novosibirsk State Medical University
Bogachev-Prokofiev A.V.
Meshalkin National Medical Research Center
Received:
17.10.2023
Accepted:
09.11.2023
List of references:
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