Surgical intervention for infective endocarditis in infancy and childhood

Background. Infective endocarditis is an uncommon but serious disease in children. Optimal treatment strategy, especially surgical indications, continues to evolve. Methods. Retrospective review of 98 patients treated for infective endocarditis during the past 13 years at the Royal Childrenʹs Hospital, including medically and surgically treated patients. Results. Thirty of 98 patients had surgical intervention with 6.7% hospital mortality, and 76% survival probability at 45 months. The remaining patients were treated medically, with 10% hospital mortality and 52% 5-year survival probability. The incidence of structural heart disease, congestive heart failure, and spectrum of organisms was similar in the two groups. Conclusions. Despite advances in antibiotic therapy, early surgical intervention is required in a significant subset. Concurrent intracardiac repair may be appropriate.