Thorac Cardiovasc Surg 2017; 65(S 02): S111-S142
DOI: 10.1055/s-0037-1599005
DGPK Oral Presentations
Monday, February 13th, 2017
DGPK: Endocarditis
Georg Thieme Verlag KG Stuttgart · New York

Are Adults with Congenital Heart Disease Informed about Their Risk for Infective Endocarditis and Treated in Accordance to Current Guidelines?

P.C. Helm
1   Nationales Register für angeborene Herzfehler e. V., DZHK (German Centre for Cardiovascular Research), Berlin, Germany
,
G.-P. Diller
2   Universitätsklinikum Münster, Kardiologisches Zentrum für Erwachsene mit angeborenen (EMAH) and erworbenen Herzfehlern, Münster, Germany
,
H. Kaemmerer
3   Department of Paediatric Cardiology and Congenital Heart Defects, Technical University of Munich, German Heart Centre Munich, DZHK (German Centre for Cardiovascular Research), Partner Site Munich, München, Germany
,
U.M.M. Bauer
1   Nationales Register für angeborene Herzfehler e. V., DZHK (German Centre for Cardiovascular Research), Berlin, Germany
,
B. Asfour
4   Asklepios Klinik Sankt Augustin GmbH, German Pediatric Heart Center, Sankt Augustin, Germany
,
O. Tutarel
5   Medizinische Hochschule Hannover, Klinik für Kardiologie und Angiologie, Hannover, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
02 February 2017 (online)

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Background: Infective endocarditis (IE) is associated with significant morbidity and mortality. Adults with congenital heart disease (ACHD) have an increased risk for developing IE. In the last decade the guideline recommendations for antibiotic prophylaxis of IE have changed substantially. Whether and to what extent those changes have been implemented into clinical practice is unknown. Especially the knowledge level of patients has not been studied.

Purpose: To study the current knowledge level of ACHD patients regarding IE and antibiotic prophylaxis of IE.

Methods: Patients recruited via the German National Register for Congenital Heart Defects were invited to an online survey about IE. 1,458 patients (53.3% women) participated. Out of these in 1,211 patients (mean age: 30.5 ± 11.8 years, female = 44.1%) detailed information regarding the CHD as well as clinical data from medical records were available. These patients were included into the study. Patients were divided into three groups based on current ESC guideline recommendations for antibiotic prophylaxis of IE: A) IE prophylaxis recommended, B) IE prophylaxis is not required, C) a conclusive statement regarding IE prophylaxis not possible.

Results: Group A: 343 patients (mean age: 31.8 ± 11.2 years, female = 53.1%); Group B: 714 patients (mean age 29.1 ± 10.8 years, female = 53.9%); Group C: 154 patients (mean age 33.9 ± 15.7 years, female = 57.1%). A regular treatment in a tertiary medical environment took place in 76.1% (group A), 66.1% (group B) and 40.9% (group C). Within the last five years, 67.3% (group A), 52.8% (group B) and 26.6% (group C) were informed by a physician about IE. In 47.8% (group A), 28% (group B) and 16.9% (group C) the discussion was initiated by a physician. Knowledge regarding IE was present in 82.5% (group A), 73.2% (group B), and 62.3% (group C), while in 70.6% (group A), 37.7% (group B) and 16.9% (group C) an increased risk of IE was present according to their own opinion. Knowledge of antibiotic prophylaxis was present in 82.2% (group A), 63.7% (group B), and 42.2% (group C).

Conclusion: This study reveals important knowledge gaps regarding IE/antibiotic prophylaxis in ACHD. Even 20–30% of ACHD with a strict recommendation for using antibiotic prophylaxis, did not possess knowledge about IE and misjudged their risk for IE. A discussion about IE and antibiotic prophylaxis should take place with every ACHD patient during regular clinical contacts to close this knowledge gap.