Retrospective Analysis of Clinical Characteristics and Surgical Treatment of Congenital Heart Disease Complicated by Infective Endocarditis From 2009 to 2023

Background: A retrospective study was conducted to gain an insight into the clinical characteristics and current surgical treatment status of patients with congenital heart disease (CHD) complicated with infective endocarditis (IE). Methods: This research included 110 patients with CHD and IE (74 males and 36 females) who underwent surgical treatment at the Cardiac Surgery Department of the First Affiliated Hospital of Xinjiang Medical University from January 1, 2009 to December 31, 2023. The patients were retrospectively evaluated, and clinical data, blood culture pathogenic types, echocardiography and treatment effects, and all-cause 1-year mortality, etc., were obtained. Results: A total of 110 patients with CHD combined with IE were enrolled, and their average age was 36.7 ± 15.1 years. Atrial septal defects (ASDs) (32.7%) and ventricular septal defects (VSDs) (24.6%) were the most common basic congenital heart classifications. Blood culture was positive in 54 cases (49.1%). The Streptococcus group was dominant in 32 cases (59.3%), and Streptococcus viridans (22.1%) was the most common pathogen. Vegetation was detected through transthoracic echocardiography of 91 patients, and left IE (60.4%) was more common than right IE (27.5%). All 110 patients underwent surgery, and the most common postoperative complications were heart failure (12.7%) and renal insufficiency (9.1%). Six cases of in-hospital death were recorded (5.5%). The main causes of death included low cardiac output syndrome and acute cerebral infarction. Overall, the in-hospital and one-year survival rates were 94.5% and 85.5%, respectively. Conclusions: This study revealed that young and middle-aged male patients with CHD combined with IE were more common, ASDs and VSDs were common, and Streptococcus was the main pathogenic bacteria. Echocardiography is critical to diagnosis, which emphasizes the importance of early diagnosis and surgical intervention.