| Autor: |
Nasso G; GVM Care < Research, Department of Cardiovascular Surgery, Anthea Hospital, Bari, Italy., Condello I; GVM Care < Research, Department of Cardiovascular Surgery, Anthea Hospital, Bari, Italy., D'Abramo M; Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy., De Luca A; Department of Clinical and Molecular Medicine, Cardiac Surgery Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy., Larosa C; Azienda Ospedaliera BAT, Bonomo Hospital, Andria, Italy., Valenti G; Azienda Ospedaliera BAT, Bonomo Hospital, Andria, Italy., Bartolomucci F; Azienda Ospedaliera BAT, Bonomo Hospital, Andria, Italy., Di Bari N; Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy., Sechi S; GVM Care < Research, Department of Cardiovascular Surgery, San Carlo di Nancy, Rome, Italy., Diaferia G; Azienda Ospedaliera BAT, P.P.A. Canosa di Puglia, Italy., De Rosis MG; Azienda Ospedaliera Bari, Bari, Italy., Amodeo V; Ospedale degli Ungheresi, Polistena, Italy., Melina G; Department of Clinical and Molecular Medicine, Cardiac Surgery Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy., Speziale G; GVM Care < Research, Department of Cardiovascular Surgery, Anthea Hospital, Bari, Italy.; Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.; Department of Clinical and Molecular Medicine, Cardiac Surgery Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.; Azienda Ospedaliera BAT, Bonomo Hospital, Andria, Italy.; GVM Care < Research, Department of Cardiovascular Surgery, San Carlo di Nancy, Rome, Italy., Vignaroli W; GVM Care < Research, Department of Cardiovascular Surgery, Anthea Hospital, Bari, Italy.; Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.; Department of Clinical and Molecular Medicine, Cardiac Surgery Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.; Azienda Ospedaliera BAT, Bonomo Hospital, Andria, Italy.; GVM Care < Research, Department of Cardiovascular Surgery, San Carlo di Nancy, Rome, Italy. |
| Abstrakt: |
Infective endocarditis (IE) on atrial septal defect (ASD) closure devices, while extremely rare, has been reported to be more frequent early after the procedure. We describe a case of late IE after percutaneous closure of patent foramen ovale (PFO). We also performed a literature review on this subject. We reviewed a total of 42,365 patients who were treated with percutaneous devices: 13,916 for ostium secundum (OS) (32%), 24,726 for PFO (58%) and 3,723 for OS+PFO (8%). Among these patients, we identified 50 cases of IE after atrial septal defect device closure (0.001%). In contrast to previous reports, nearly 66% of IE in this setting occurred late, after at least 6 months from the procedure (33/50 patients). A statistical analysis clearly showed that the mean time from the procedure to IE increased in the last five years, probably associated with a change in antiplatelet therapy after ASD closure. Management of IE on an ASD occluder should always be discussed in the setting of a multidisciplinary heart team that includes a cardiologist, cardiac surgeon, and anesthetist. While surgical strategies gave excellent results, conservative management might be considered in cases of small IE vegetations and for patients in good general condition. However, in these cases, the patient must be closely observed with repeated blood and instrumental tests. |
