Surgical repair of congenital heart disease combined with endocarditis

Cheliabinsk Interregional Cardiac Surgery Center Secondary infective endocarditis (IE) complicates congenital heart diseases (CHD) in 5.9-12 % of cases. There are two major conditions for IE development: endothelium damage and presence of microorganisms in the blood stream [2,3,5,8]. Therefore, in many cases secondary IE occurs on congenitally changed valves of the heart - bicuspid aortic valve and mitral valve prolapse [1,4,6,7,9]. Injuries of endocardium caused by turbulent blood streams in patients with such CHD as septal defects or patent ductus arteriosus might be considered as one of the mechanisms for developing endocarditis of right cardiac chambers [3, 5, 8]. In some cases, when CHD is complicated by IE, cardiac aneurysms may occur, with myocardium being damaged as a result of embolism of coronary arteries by a septic embolus and with subsequent development of myocardium abscess. High intercardial pressure contributes to the development of deformity in the area of the affected region of myocardium and to the growth of postmyocardiac aneurysm of the ventricle [3]. All this helps to make a conclusion that repair of CHD is justified not only because of hemodynamic criteria but for the benefit of preventing IE [1, 3, 4, 5, 6, 9].