Infective Endocarditis in Adult Patients With Congenital Heart Disease.

Patients with adult congenital heart disease (ACHD) represent a growing population at increased risk for infective endocarditis (IE). Their susceptibility is due to specific factors such as uncorrected native congenital defects, previous surgical repairs involving patches or prosthetic materials, and residual shunts or percutaneously implanted devices. These elements increase the likelihood of infection. Anatomical complexities-such as anteriorly located structures, right ventricle to pulmonary artery conduits, surgically or percutaneously implanted valves and pulmonary valve replacements-along with vulnerability to atypical organisms, further complicate diagnosis. Multidisciplinary IE teams including ACHD specialists, together with advanced multimodality imaging, can significantly improve diagnostic accuracy. Although ACHD patients might have lower overall mortality from IE compared with non-congenital heart disease populations, the condition remains high-risk and potentially life-threatening. Early recognition and prompt treatment are critical. Prevention strategies-particularly maintaining dental and skin hygiene, and careful management of intravenous lines-are essential in reducing IE risk in this population. Patient education remains paramount. Continued research into risk stratification, accelerated diagnostic pathways, and effective treatment protocols is vital to improving outcomes for ACHD patients at risk of IE.