关键词: 感染性心内膜炎, 先天性心脏病, 胸腔手术

Abstract: Objective: To summarize the clinical characteristics and management of infective endocarditis(IE) in adult patients with congenital heart disease (CHD) and to identify the predictors of outcome. Methods: From January 2001 to December 2010, fifty-one adult patients with CHD and definite IE based on the Duke criteria were enrolled; the clinical data were retrospectively reviewed．Results: 20.6% IE patients had shunt CHD. Ventricular septal defect and patent ductus arteriosus were the most common underlying defects. Streptococci were the most common causative organisms (47.1%). 27 patients（52.9%）had complications. The frequent complications were valve destruction and embolic events. 38 patients (58.8%) underwent cardiac surgery, the operation were performed during the active phase of infective endocarditis in 21 cases. The overall mortality rate was 19.6%. Logistic regression analysis identified presence of severe heart failure [OR 0.293（0.045-0.347），p =0.012] and central nervous system complications [OR 0.308（0.074-0.63），p =0.014] as predictors of overall mortality. Surgical intervention was independently associated with lower overall mortality [OR 0.238（0.009-0.183），p =0.031]. Conclusion: Ventricular septal defect and patent ductus arteriosus were the most common underlying defects in IE patients with CHD. The mortality of IE in patients with CHD was high. Presence of severe heart failure and central nervous system complication were independently predictors of mortality. Surgical intervention reduces the risk of mortality of IE in patients with CHD .

Key words: endocarditis, bacterial, heart defects, congenital, thoracic Surgery