The Application Value Of Transthoracic Echocardiography In Evaluating Congenital Heart Disease Complicated With Infectious Endocarditis

Objective To analyze the clinical value of transthoracic echocardiography(TTE)in differential diagnosis of congenital heart disease(CHD)complicated with infectious endocarditis(IE)and the guiding significance of TTE for its prognosis.Methods A retrospective analysis was made of the clinical data and TTE results in 85 CHD complicated with IE patients discharged from the First Affiliated Hospital of Guangxi Medical University from March 2011 to June2018.The collection includes:(1)routine data such as patient age,gender,fever,and discharge diagnosis.(2)TTE results before and after surgery: cardiac morphology and wall contraction,size and activity of vegetation,valve opening and closure,LVEDD,LAESD,RVEDD,LVEF.Results 1.Among 85 CHD complicated with IE patients,31 cases(36.5%)had ventricular septal defect.And aortic valve was the most common sites of vegetation attachment.2.For the comparison of cardiac basic lesions,the locati-on and size of vegetations,TTE examination result was in good agreement with the results of surgery.The changes of LVEDD,LAESD,RVEDD and LVEF value before and after surgery had statistical significance(P < 0.05).3.CHD complicated with IE patients with complications,41 cases(47.7%)with valvular insufficiency and 35 cases(40.7%)with pericardial effusion.After single factor statistical analysis,the comparison between cardiac function grade III?IV group and cardiac function grade I?II group showed that moderate and moderate valvular regurgitation was more common in cardiac function grade III? IV group(54.8% vs 27.9%,P = 0.016),and the incidence of pericardial effusion was also higher(40.5% vs 18.6%,P = 0.00).No statistically significant difference in age,sex,body temperature and duration of fever between the other two groups.There was no significant difference in echocardiographic data such as intracardiac shunt,LVEDD,size of vegetation,vegetation activity,LVEF and so on.Further multivariate logistic analysis showed that moderate and above valvular regurgitation and a small amount or more pericardial effusion were risk factors for severe impairment of cardiac function.4.In this study,one patient was successfully treated with minimally invasive interventional therapy.No embolism complications after 3 years follow-up,and 2 patients with IE after minimally invasive interventional therapy.Conclusion 1.Ventricular septal defect is the most common cardiac basic lesion in this study,and aortic valve is the most frequent location to be infected.2.TTE is highly sensitive to the detection of vegetation,and can observe the location and size of vegetation in detail,which is of great significance for the early diagnosis of diseases.3.CHD complicated with IE patients are prone to severe cardiac dysfunction.Moderate and above valvular regurgitation and pericardial effusion are risk factors for severe cardiacdysfunction in CHD complicated with IE patients.