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JAMA. 1998 Feb 25;279(8):599-603.

Thirty-year incidence of infective endocarditis after surgery for congenital heart defect.

Author information

1
Congenital Heart Disease Research Center, Division of Medical Informatics and Outcomes Research, Oregon Health Sciences University, Portland 97201, USA.

Abstract

CONTEXT:

The incidence of infective endocarditis after surgical repair of congenital heart defects is unknown.

OBJECTIVE:

To determine the long-term incidence of endocarditis after repair of any of 12 congenital heart defects in childhood.

DESIGN:

Population-based registry started in 1982.

SETTING:

State of Oregon.

PARTICIPANTS:

All Oregon residents who underwent surgical repair for 1 of 12 major congenital defects at the age of 18 years or younger from 1958 to the present.

MAIN OUTCOME MEASURE:

Diagnosis of infective endocarditis confirmed by hospital or autopsy records.

RESULTS:

Follow-up data were obtained from 88% of this cohort of 3860 individuals through 1993. At 25 years after surgery, the cumulative incidence of infective endocarditis was 1.3% for tetralogy of Fallot, 2.7% for isolated ventricular septal defect, 3.5% for coarctation of the aorta, 13.3% for valvular aortic stenosis, and 2.8% for primum atrial septal defect. In the cohorts with shorter follow-up, at 20 years after surgery the cumulative incidence was 4.0% for dextrotransposition of the great arteries; at 10 years, the cumulative incidence was 1.1% for complete atrioventricular septal defect, 5.3% for pulmonary atresia with an intact ventricular septum, and 6.4% for pulmonary atresia with ventricular septal defect. No children with secundum atrial septal defect, patent ductus arteriosus, or pulmonic stenosis have had infective endocarditis after surgery.

CONCLUSION:

The continuing incidence of endocarditis after surgery for congenital heart defect, particularly valvular aortic stenosis, merits education about endocarditis prophylaxis for children and adults with repaired congenital heart defects.

PMID:
9486754
DOI:
10.1001/jama.279.8.599
[Indexed for MEDLINE]

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