Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2015; 7(10): 703-706
Published online Oct 26, 2015. doi: 10.4330/wjc.v7.i10.703
Late endocarditis of Amplatzer atrial septal occluder device in a child
Neerod K Jha, Laszlo Kiraly, John SK Murala, Csaba Tamas, Haitham Talo, Hazem El Badaoui, Magdi Tofeig, Malaika Mendonca, Sameer Sajwani, Mary A Thomas, Sura Ahmed Al Doory, Mohammad D Khan
Neerod K Jha, Laszlo Kiraly, John SK Murala, Csaba Tamas, Department of Pediatric Cardiac Surgery, Sheikh Khalifa Medical City (managed by Cleveland Clinic), Abu Dhabi, United Arab Emirates
Haitham Talo, Hazem El Badaoui, Magdi Tofeig, Mohammad D Khan, Department of Pediatric Cardiology, Sheikh Khalifa Medical City (managed by Cleveland Clinic), Abu Dhabi, United Arab Emirates
Malaika Mendonca, Department of Critical Care, Sheikh Khalifa Medical City (managed by Cleveland Clinic), Abu Dhabi, United Arab Emirates
Sameer Sajwani, Sura Ahmed Al Doory, Department of Cardiology, Latifa Hospital, Dubai, United Arab Emirates
Mary A Thomas, Department of Pathology, Sheikh Khalifa Medical City (managed by Cleveland Clinic), Abu Dhabi, United Arab Emirates
Author contributions: Jha NK, Kiraly L, Murala JSK, Tamas C, Talo H, El Badaoui H, Tofeig M and Khan MD designed the report and written the manuscript; Mendonca M, Sajwani S, Thomas MA and Al Doory SA analysed the data and revised it with special reference to the specialty involved; all authors were involved in the patient management.
Institutional review board statement: None.
Informed consent statement: The authors state that all involved persons (subjects or legally authorized representative) gave their informed consent (written or verbal) prior to study inclusion.
Conflict-of-interest statement: There is no conflict-of- interest in this review.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Neerod K Jha, MD, Cardiac Surgeon, Department of Pediatric Cardiac Surgery, Sheikh Khalifa Medical City, District-Karamah, Karamah Street, P.O. Box 51900, Abu Dhabi, United Arab Emirates. njha@skmc.ae
Telephone: +971-50-6107532 Fax: +971-2-8193489
Received: June 25, 2015
Peer-review started: July 12, 2015
First decision: August 14, 2015
Revised: August 24, 2015
Accepted: September 10, 2015
Article in press: September 16, 2015
Published online: October 26, 2015
Processing time: 131 Days and 5.4 Hours
Abstract

Bacterial endocarditis following atrial septal defect closure using Amplatzer device in a child is extremely rare. We report a 10-year-old girl who developed late bacterial endocarditis, 6 years after placement of an Amplatzer atrial septal occluder device. Successful explantation of the device and repair of the resultant septal defect was carried out using a homograft patch. The rare occurrence of this entity prompted us to highlight the importance of long-term follow up, review the management and explore preventive strategies for similar patients who have multiple co-morbidities and a cardiac device. A high index of suspicion is warranted particularly in pediatric patients.

Keywords: Endocarditis; Atrial; Septal; Device

Core tip: Bacterial endocarditis following atrial septal defect closure using Amplatzer device in a child is extremely rare. We report a 10-year-old girl who developed late bacterial endocarditis, 6 years after placement of an Amplatzer atrial septal occluder device. This case report demonstrates the need for long-term follow up of patients with intracardiac device especially those with multiple co-morbidities or who have vulnerability to infection due to poor general condition or extremes of age such as our’s. A high index of suspicion for device complication is required if sepsis or embolic phenomenon found. Incomplete endothelization of the prosthetic devices may be linked to endocarditis and needs to be explored.