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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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References

1.Geva, T, Frand, M: Infective endocarditis in children with congenital heart disease; the changing spectrum, 1965–85. Eur Heart J 1988; 9: 1244–1249.CrossRefGoogle ScholarPubMed
2.Gilbert, BW, Haney, RS, Crawford, F, McClellan, J, Gallis, HA, Johnson, ML, Kisslo, JA. Two-dimensional echocardiographic assessment of vegetative endocarditis. Circulation 1977; 55: 346–353.CrossRefGoogle ScholarPubMed
3.Livornese, LL, Korzeniowski, OM. Pathogenesis of infective endocarditis. In: Kaye, D, ed. Infective Endocarditis. Raven Press, New York , 1992 pp.19–35.Google Scholar
4.Lepeschkin, E. On the relationship between the site of valvular involvement in endocarditis and the blood pressure resting on the valve. Am J Med Sci 1952 ; 224: 316–319.CrossRefGoogle Scholar
5.Scheld, WM. Pathogenesis and pathophysiology of infective endocarditis. In: Sande, MA, Kaye, D, Root, RK, eds. Endocarditis. Contemporary Issues in Infectious Diseases. Churchill Livingstone, London, 1984, pp 1–32.Google ScholarPubMed
6.Bisno, AL, Dismukes, WE, Durack, DT, Kaplan, EL, Karchmer, AW, Kaye, D, Rahimtoola, SH, Sande, MA, Sanford, JP, Watanakunakorn, C, Wilson, WR.Antimicrobial treatment of infective endocarditis due to viridans streptococci, enterococci, and staphylococci. JAMA 1989; 261: 1471–1477.CrossRefGoogle ScholarPubMed
7.Kaplan, EL, Shulman, ST. Endocarditis. In: Adams, FH, Emmnouilides, GC, Riemenschneider, TA, eds. Moss' Heart Disease in Infants, Children, and Adolescents. Williams and Wilkins, Baltimore, 1989 pp.718–730.Google Scholar
8.Freedman, LR, Valone, J.Experimental infective endocarditis. Prog Cardiovasc Dis 1979; 22:169–180.CrossRefGoogle ScholarPubMed
9.Kirklin, JW, Barratt-Boyes, BG. Ventricular Septal Defects and Pulmonary Stenosis or Atresia. In Kirklin, JW, Barratt-Boyes, BG, eds. Cardiac Surgery. Churchill Livingstone, New York, 1993 pp 863–973.Google ScholarPubMed