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Sterile vegetations in children with severe tetralogy of Fallot

Published online by Cambridge University Press:  19 August 2008

Antoinette M. Cilliers ,
Kathy M. Vanderdonck ,
Jan P. du Plessis ,
Stefanus L. Cronje  and
Solomon E. Levin
Antoinette M. Cilliers
Affiliation:
Division of Pediatric Cardiology, Chris Hani Baragwanath Hospital and The University of the Witwatersrand, Johannesburg, South Africa
Kathy M. Vanderdonck
Affiliation:
Division of Pediatric Cardiology, Chris Hani Baragwanath Hospital and The University of the Witwatersrand, Johannesburg, South Africa
Jan P. du Plessis
Affiliation:
Division of Pediatric Cardiology, Chris Hani Baragwanath Hospital and The University of the Witwatersrand, Johannesburg, South Africa
Stefanus L. Cronje
Affiliation:
Division of Pediatric Cardiology, Chris Hani Baragwanath Hospital and The University of the Witwatersrand, Johannesburg, South Africa
Solomon E. Levin
Affiliation:
Division of Pediatric Cardiology, Chris Hani Baragwanath Hospital and The University of the Witwatersrand, Johannesburg, South Africa
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Abstract

The finding of bland, sterile vegetations in children with severe tetralogy of Fallot is unexpected, and to our knowledge, has not been reported previously. Eight patients diagnosed with tetralogy between January 1993 and July 1997 had sterile vegetations proven by histological and microbiological evaluation, in their right ventricular outflow tracts. Four of these patients were experiencing severe hyper-cyanotic spells, and four had severely reduced effort tolerance at presentation. They all underwent cardiac catheterization and were submitted for surgical repair. At surgery, the vegetations were thought to be causing further narrowing of the already tight fibrotic infundibular stenosis. Two of these patients had evidence of damaged valves, without evidence of active endocarditis. Although initially sterile, these vegetations, may in some instances, become infected.

Keywords

Tetralogy of Fallotvegetationsendocarditisechocardiographyhypercyanotic spells
Type
Original Articles
Information
Cardiology in the Young , Volume 8 , Issue 4 , October 1998 , pp. 440 - 442
Copyright
Copyright © Cambridge University Press 1998

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