procedure for fungal endocarditis

hi thnks a lot for replying back. just wanted to know which kind of prrocedure are surgeons opting in case of a 4 yr old withfungal endocarditis on homograft?? Do they replace the graft with another one or shunting is needed so as to repeat the conduit some years later?? thanks

[Jeffrey R Boris, M.D.]

Dear Heartmum,

Without knowing all of the details of the anatomy, it is difficult to say what exactly could be done.  However, a homograft replacement is the potential intervention.  That said, surgical intervention during active fungal endocarditis is likely to be extremely high risk, since fungus is difficult to eradicate and can easily infect the new homograft.  As well, the stress of surgical intervention is likely to weaken the immune system.  Therefore, antimicrobial elimination of the fungus is going to be the most important approach at this point.