The relationship between the extent of valve damage and pre-existing intracardiac pathology in children with infective endocarditis
DOI:
https://doi.org/10.14739/2310-1210.2025.6.336213Keywords:
congenital heart defects, heart valve, organ sparing treatments, risk factors, infective endocarditis, odds ratioAbstract
Aim. To identify an association between the extent of heart valve damage and pre-existing intracardiac pathology in children with infective endocarditis.
Materials and methods. The study included pediatric patients with a mean age of 8.9 ± 3.3 years (age range: 3.0 to 14.8 years). All participants had a history of infective endocarditis, as defined by the modified Duke criteria, with involvement of the heart’s valvular apparatus. All patients underwent reconstructive heart valve surgeries at the Department of Surgical Treatment of Congenital Heart Defects in Newborns and Young Children at the SI “Amosov National Institute of Cardiovascular Surgery, National Academy of Medical Sciences of Ukraine”. The data for analysis were extracted from primary medical records, including medical history charts, operative protocols, and clinical and instrumental examination data. All patients (or their parents) provided informed voluntary consent.
Results. The paper presents findings on the anatomical features of congenital heart defects that preceded the development of infective endocarditis. Non-cyanotic congenital heart defects were found to be the predominant pre-existing pathology (92.4 %) compared to cyanotic defects (7.6 %). Lesions of the heart’s valvular apparatus were also analyzed, which influenced the type of surgical intervention (organ-sparing vs. prosthetic replacement). Aortic valve lesions were significantly more frequent (29.6 %) than mitral (χ2 = 9.68; p = 0.002) and tricuspid (χ2 = 20.70; p = 0.0001) lesions. An association was found between the extent of heart valve damage and the pre-existing intracardiac pathology.
Conclusions. Organ-sparing operations significantly prevailed in the comparison group. However, in the main group, mitral valve replacement significantly outnumbered organ-sparing procedures (χ2 = 4.55; p = 0.03). The risk of valve replacement in the main group was found to be 2.5 times higher compared to patients without congenital heart defects (OR = 2.50; 95 % CI: 0.64–9.65; p = 0.1).
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