Surgical treatment of infectious endocarditis in a child using a hemosorption column: a clinical case

• Teplov P.V.
• Gvozd E.M.
• Miller A.Yu.
• Petrov A.S.
• Afanasyev I.S.
• Vityutneva A.V.
• Drobot D.B.
• Sakovich V.A.

Abstract

Infectious endocarditis affects the valvular structures of the heart, causing their destruction, accompanied by systemic inflammatory and autoimmune reactions. Currently, the mortality rate from infectious endocarditis reaches 30%, surgical intervention can reduce hospital mortality in such patients to 4.8–14.3%. The decision on surgical intervention in pediatric patients with infectious endocarditis of the heart valves and the timing of its implementation remains controversial, especially among those who have complications from the central nervous system and septic complications. In this paper, we presented a description of a case of successful simultaneous prosthetics of the aortic and mitral valves in a child with secondary infectious endocarditis using a hemosorption column during artificial circulation to remove endotoxins and cytokines.

Keywords: infectious endocarditis; aortic valve replacement; mitral valve replacement; hemosorption column

References

1.     Caldonazo T., Hagel S., Doenst T., Kirov H., Sá M.P., Jacquemyn X., et al. Conservative versus surgical therapy in patients with infective endocarditis and surgical indication-meta-analysis of reconstructed time-to-event data. J Am Heart Assoc. 2024; 13 (7): e033404. DOI: https://doi.org/10.1161/JAHA.123.03340

2.     Delgado V., Marsan N.A., de Waha S., Bonaros N., Brida M., Burri H., et al. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J. 2023; 44 (39): 3948–4042. DOI: https://doi.org/10.1093/eurheartj/ehad193

3.     Sharma M., Davis A.P. Adding fuel to the fire: Infective endocarditis and the challenge of cerebrovascular complications. Curr Cardiol Rep. 2023; 25 (5): 349–56. DOI: https://doi.org/10.1007/s11886-023-01856-z

4.     Demin A.A., Kobalava Zh.D., Skopin I.I., Tyurin P.V., Boytsov S.A., Golukhova E.Z., et al. Infectious endocarditis and infection of intracardiac devices in adults. Clinical guidelines 2021. Rossiyskiy kardiologicheskiy zhurnal [Russian Journal of Cardiology]. 2022; 27 (10): 113–92. DOI: https://doi.org/10.15829/1560-4071-2022-5233 (in Russian)

5.     Kopitsyna M.N., Morozov A.S., Bessonov I.V., Pisarev V.M., Lobakova E.S., Bukharin O.V. Ligands for selective removal of lipopolysaccharides from gram negative bacteria. Zhurnal mikrobiologii, epidemiologii i immunobiologii [Journal of Microbiology, Epidemiology and Immunobiology]. 2017; (3): 115–26. DOI: https://doi.org/10.36233/0372-9311-2017-3-115-126 (in Russian)

6.     Sarana A.M., Shcherbak S.G., Vologzhanin D.A., Golota A.S., Kamilova T.A., Makarenko S.V. Efferent methods of therapy for critical illness. Fizicheskaya i reabilitatsionnaya meditsina: meditsinskaya reabilitatsiya [Physical and Rehabilitation Medicine, Medical Rehabilitation]. 2024; 6 (1): 49–72. DOI: https://doi.org/10.36425/rehab626652 (in Russian)

7.     Kuanyshbek A.S., Lesbekov T.D., Bekishev B.E., Kaliev R.B., Dzhabaeva N.A., Faizov L.R. Hemadsorption in infectious endocarditis requiring open heart surgery. Clinical and Experimental Surgery. Petrovsky Journal. 2023; 11 (3): 116–25. DOI: https://doi.org/10.33029/2308-1198-2023-11-3-116-125 (in Russian)

8.     Haidari Z., Wendt D., Thielmann M., Mack owiak M., Neuhäuser M., Jakob H., et al. Intraoperative hemoadsorption in patients with native mitral valve infective endocarditis. Ann Thorac Surg. 2020; 110 (3): 890–6. DOI: https://doi.org/10.1016/j.athoracsur.2019.12.067

9.     Asch S., Kaufmann T.P., Walter M., Leistner M., Danner B.C., Perl T., et al. The effect of perioperative hemadsorption in patients operated for acute infective endocarditis – a randomized controlled study. Artif Organs. 2021; 45 (11): 1328–37. DOI: https://doi.org/10.111 1/aor.14019

10. Yaroustovsky M., Abramyan M., Rogalskaya E., Komardina E. Selective polymyxin hemoperfusion in complex therapy of sepsis in children after cardiac surgery. Blood Purif. 2021; 50 (2): 222–9. DOI: https://doi.org/10.1159/000510126

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)