PMID: 3755471Jul 1, 1986Paper

Management of vascular complications of bacterial endocarditis

Journal of Pediatric Surgery
D K NakayamaR H Dean

Abstract

Peripheral arterial emboli that result from bacterial endocarditis may be silent or catastrophic. Cardiac surgical intervention may prevent embolism, but the guidelines for timing of intervention are unclear. An accepted approach is to intervene only if two episodes of peripheral embolism occur. Our recent experience suggests a more refined approach is in order. Eight children with active bacterial endocarditis have been treated with embolic complications. One patient with abdominal pain and GI bleeding was treated with heparin for multiple peripheral mesenteric emboli. Four patients had femoral embolectomies, one twice. Three patients developed embolomycotic aneurysms of the aorta in two cases and the common iliac in one; all were ruptured and two survived with staged reconstruction in one and extra-anatomic bypass in the other. Staph aureus and Strep viridans were the organisms involved most often. A review of the details of care in these patients leads to the following conclusions: angiographic survey reveals that most patients have multiple emboli; early embolectomy may prevent formation of infected aneurysms; Staph aureus infected patients are at risk for development of infected aneurysms; patients with large floppy vegeta...Continue Reading

References

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Citations

Mar 10, 2001·Cardiology in the Young·T A WalkerM R Ebeid
Jul 29, 2015·International Journal of Surgery Case Reports·H NaouliA Bouarhroum
Aug 1, 1996·Cardiology Clinics·P S Harris, C G Cobbs
Dec 1, 1989·Journal of Cardiac Surgery·W J Wells
Jun 1, 1990·Acta paediatrica Scandinavica·L CharafA Henze
Jan 1, 1989·Scandinavian Journal of Thoracic and Cardiovascular Surgery·L CharafA Henze
Aug 23, 2016·World Journal of Emergency Medicine·George GalyfosChrisostomos Maltezos

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