Mitral valve vegetations in a 16-year-old girl, surgically treated with minimally invasive reconstruction

Abstract

Infective endocarditis in children is a rare complication and is most often associated with dental interventions. It may develop in course of congenital and acquired heart defects, as well as previous cardiac surgeries. The case regards a 16-year-old girl reporting significant fatigue, low-grade fever, lack of appetite with a weight loss of 5 kg, apathy, and enlargement of the spleen over six months before admission. Physical examination exposed systolic murmur in the apical region. The patient was admitted to a general paediatric ward and then, after confirming vegetation on the mitral valve, further treatment was carried out in the paediatric cardiology ward. The blood cultures revealed Streptococcus Gordoni infection. Intensive antibiotic treatment was initiated under the control of blood cultures, which were negative after 7 days of treatment. An interdisciplinary council meeting decided to continue the treatment. Cardiosurgical consult resulted in transferring the patient to the adult cardiosurgery ward, even though she was not of age, where a minimally invasive valve reconstruction was performed using artificial tendon threads and an artificial Carpentier–McCarthy–Adams 26 mm mitral ring. The postoperative course was uneventful and the girl was returned to the care of paediatric cardiologists. Currently, she is in good condition and is under constant control.