A Case of Mitral Valve Endocarditis Complicated by Multiple Embolic Phenomena: Leaping from Adult Guidelines to Pediatric Critical Care Decisions

Author:

Choudhury Tarif A.1,Flyer Jonathan N.2,Ushay Henry M.3,Ofori-Amanfo George4

Affiliation:

1. Department of Pediatrics, Division of Pediatric Cardiology and Pediatric Critical Care Medicine, Columbia University Medical Center, Morgan Stanley Children's Hospital of New York, New York, New York, United States

2. Department of Pediatrics, Division of Pediatric Cardiology, The Robert Larner, M.D. College of Medicine at The University of Vermont, University of Vermont Children's Hospital, Burlington, Vermont, United States

3. Department of Pediatrics, Division of Pediatric Critical Care Medicine, Albert Einstein College of Medicine, The Children's Hospital at Montefiore, Bronx, New York, United States

4. Department of Pediatrics, Division of Pediatric Critical Care Medicine, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, New York, United States

Abstract

AbstractEarly surgical intervention for children with infective endocarditis (IE) and cerebrovascular sequelae has significant risks, resulting in practice variation amongst pediatric cardiologists, intensivists, and cardiothoracic surgeons. The limited pediatric consensus recommendations make decision making for practitioners challenging. The added risk of multiorgan dysfunction syndrome can make these decisions even more difficult. We present the case of a 14-year-old with IE and resultant multiorgan dysfunction syndrome including cerebrovascular complication, successfully treated by primary valve repair within the 1st week of diagnosis.

Publisher

Georg Thieme Verlag KG

Subject

Critical Care and Intensive Care Medicine,Pediatrics, Perinatology, and Child Health

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