Pediatric Heart Expert Forum
Severe Mitral valve reguritation at 6 months due to Endocarditis
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Severe Mitral valve reguritation at 6 months due to Endocarditis

Hello,
My son at 6 months had severe mitral valve regurgitation due to endocarditis. We have always kept a clean envioronment in the house and always made sure all his baby items were always clean. We also avoided going out to crowded areas. He was born very strong and healthy and he had no health problems.Could you please give me some causes of endocarditis that happens to a baby born very healthy? We were told that his chances of having had a heart defect from birth was low since he was gaining weight very well. I can't help but wonder if my son may already have had damage to his mitral valve from birth? If so, I suppose he wouldn't have been able to gain a good amount of weight as he has. He always had lots of energry too. He had two open heart surgeries. First was mitral valve repair and two weeks later, he had a second operation where he had mitral valve annuloplasty ring inserted (C shaped ring). Now he is doing great! If anyone could help me, I would  greatly appreciate any thing I should know regarding mitral valve annuloplasty ring and mitral valve reguritation. My biggest concern is the possibility for his mitral valve regurgitaion to increase (it is at minimum level at the moment) and I am very scared about his chances for reoperation. Since he is only 10 months now, what are the chances for reoperation after an half ring annuloplasry has been inserted? I was told by my doctor that he may need surgery again when he arrives at a age where his weight is doubled his current weight. Now he is 9kg. The doctor told me since it is a half circle ring, the other side is free meaning if the mitral valve grows well in harmony with the ring, he could aviod future surgery but if problems occur as his body gets bigger with age, he may require more surgery. Please if possible, I would greatly appreciate it if you could give me some advice. I am very worried about his future, I would greatly appreciate any feedback. Thank you!
773655_tn?1340656399
Bacterial endocarditis is a rare occurrence in infants who are otherwise healthy, but it can occur.  Bacteria can enter the blood stream during bacterial infections (like an ear infection) but they are usually cleared by the immune system.  If there is a structural abnormality of a heart valve, even a mild one, that is a place where the bacteria can stick and cause the heart valve infection.  There would be no good way to know of a mild valve abnormality as it would not cause any cardiac symptoms or growth problems.  Unfortunately, valve surgery is often required in this situation.  The younger a patient is at the time of valve surgery, the more likely they will need another operation in the future, as the heart valves change in size as the patient grows.  As your doctor said, things could grow steadily at the same rate and nothing will change, or they might change at different rates and the valve will leak more. There are no hard and fast statistics as to what percent need reoperation--it is an individual thing.  Often medical management is used as a first step with a leaking heart valve before embarking on another heart surgery.  Regular cardiac follow up and serial echocardiograms is the best you can do for your child.  Good luck.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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