Thirty-year incidence of infective endocarditis after surgery for congenital heart defect.

<bold>Context: </bold>The incidence of infective endocarditis after surgical repair of congenital heart defects is unknown.<bold>Objective: </bold>To determine the long-term incidence of endocarditis after repair of any of 12 congenital heart defects in childhood.<bold>Design: </bold>Population-based registry started in 1982.<bold>Setting: </bold>State of Oregon.<bold>Participants: </bold>All Oregon residents who underwent surgical repair for 1 of 12 major congenital defects at the age of 18 years or younger from 1958 to the present.<bold>Main Outcome Measure: </bold>Diagnosis of infective endocarditis confirmed by hospital or autopsy records.<bold>Results: </bold>Follow-up data were obtained from 88% of this cohort of 3860 individuals through 1993. At 25 years after surgery, the cumulative incidence of infective endocarditis was 1.3% for tetralogy of Fallot, 2.7% for isolated ventricular septal defect, 3.5% for coarctation of the aorta, 13.3% for valvular aortic stenosis, and 2.8% for primum atrial septal defect. In the cohorts with shorter follow-up, at 20 years after surgery the cumulative incidence was 4.0% for dextrotransposition of the great arteries; at 10 years, the cumulative incidence was 1.1% for complete atrioventricular septal defect, 5.3% for pulmonary atresia with an intact ventricular septum, and 6.4% for pulmonary atresia with ventricular septal defect. No children with secundum atrial septal defect, patent ductus arteriosus, or pulmonic stenosis have had infective endocarditis after surgery.<bold>Conclusion: </bold>The continuing incidence of endocarditis after surgery for congenital heart defect, particularly valvular aortic stenosis, merits education about endocarditis prophylaxis for children and adults with repaired congenital heart defects. [ABSTRACT FROM AUTHOR]