Infective endocarditis of the Dacron patch—a report of 13 cases at autopsy

Abstract Aims One of the complications of using a synthetic material as a patch in correction of left-to-right shunts is the development of infection. This is an autopsy report of 13 patients who developed infective endocarditis of the Dacron patch as a postoperative complication. Methods We retrospectively reviewed the autopsy records of patients with infective endocarditis over a 15-year period (1994–2008) and selected cases with Dacron-patch infective endocarditis. The patch infective endocarditis was classified into early-onset and late-onset infective endocarditis. Results Patch infective endocarditis was seen in 13 patients affecting the patches covering an atrial septal defect and 12 ventricular septal defects. There were nine males and four females, with a mean age of 13.1 years. The episodes occurred 2 to 118 days (mean of 30) after operation, with early-onset infective endocarditis in 10 and late-onset infective endocarditis in three patients. Postoperative wound infection had been present in eight. The organisms isolated or demonstrated on microscopy included Staphylococcus aureus (5), gram-positive cocci (4), Pseudomonas (2), Aspergillus species (1), and Candida species (1). Death was related to embolization and/or accompanying septicemia. Conclusions Correction of simple or complex congenital cardiac defects offers new substrates for organisms to colonize resulting in infective endocarditis, which are often difficult to treat.