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Mustafa Yilmaz, Mehmet Oc, Bora Farsak, Süheyla Ozkutlu, Metin Demircin
Med Sci Monit 2002; 8(4): CS39-41
BACKGROUND: One of the serious potential complications of complex congenitalheart defect (CHD) is bacterial endocarditis. Right sided endocarditis accounts for 5-10% of all casesof infective endocarditis, with the tricuspid valve more frequently affected than the pulmonary valve.Pulmonary artery involvement in bacterial endocarditis is very rare, but when it exists it is almostalways associated with endocarditis of the pulmonary valve: isolated pulmonary artery vegetations havenot previously been reported before. CASE REPORT: A 6-year-old boy with atrial septal defect (ASD), ventricularseptal defect (VSD), coarctation of the aorta (CA), persistent ductus arteriosus (PDA) and pulmonaryhypertension, who had been operated for closure of PDA, correction of CA and pulmonary artery banding,was readmitted with bacterial endocarditis. In surgery, the VSD was closed with a Dacron patch usinginterrupted pledget buttressed sutures, and the ASD was closed using primary sutures. After debanding,while pulmonary arteriotomy was performed for patch angioplasty, we observed that the entire pulmonaryartery trunk, right and left pulmonary artery branches, were filled with a solid mass, which was successfullytreated by surgical excision. CONCLUSIONS: With ongoing improvements in diagnostic tools, especiallyin echocardiography, antibiotic therapy and surgery, CHD can now be treated successfully in early infancyor childhood.