Infective endocarditis after device closure of atrial septal defects: Case report and review of the literature

Catheter Cardiovasc Interv. 2017 Feb 1;89(2):324-334. doi: 10.1002/ccd.26784. Epub 2016 Sep 19.

Abstract

We report a case of late infective endocarditis in an 8-year-old boy 3 years after transcatheter closure of an atrial septal defect with the Amplatzer Atrial Septal Occluder Device. Echocardiography showed a very thick pannus lining the left atrial disc of the prosthesis, with some mobile elements. MRI showed several cerebral microemboli. The patient had dental caries and blood cultures found Staphylococcus aureus. Patient was treated with gentamicin and oxacillin before surgical removal of the prosthesis. Twenty-one cases of infective endocarditis after atrial defect device closure have been reported in the literature (13 ostium secundum ASD and 8 patent foramen ovale). Seven pediatric cases were reported. S. aureus was the most frequent bacterium. Antibiotics were administered in all cases and most patients (n = 18) underwent surgical removal of the device. Incomplete endothelialization of the prosthesis was a suggested mechanism. Two patients died after surgery. © 2016 Wiley Periodicals, Inc.

Keywords: ASD; Amplatzer Atrial Septal Occluder Device; atrial septal defect; infective endocarditis; pediatrics.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cardiac Catheterization / adverse effects*
  • Cardiac Catheterization / instrumentation
  • Child
  • Device Removal
  • Echocardiography
  • Endocarditis, Bacterial / diagnosis
  • Endocarditis, Bacterial / microbiology*
  • Endocarditis, Bacterial / surgery
  • Heart Septal Defects, Atrial / diagnostic imaging
  • Heart Septal Defects, Atrial / therapy*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Prosthesis-Related Infections / diagnosis
  • Prosthesis-Related Infections / microbiology*
  • Prosthesis-Related Infections / surgery
  • Risk Factors
  • Septal Occluder Device / adverse effects*
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / microbiology*
  • Staphylococcal Infections / surgery
  • Staphylococcus aureus / isolation & purification*
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents