Background: The mortality of infective endocarditis (IE) in children is high and it is controversial over timing of surgery for this disease. This study was undertaken to explore the strategy of surgical treatment for IE in children.

Methods: Of 43 patients with IE, 38 had underlying heart diseases, including congenital heart disease (30 patients), rheumatic heart disease (6), hypertrophic cardiomyopathy (1), and postoperative Falot’s tetrology (1). In these patients, 28 underwent surgery, and 10 were treated by medication. In the remaining 5 patients who did not have any underlying heart diseases, 4 showed post-IE valve lesions, and 1 valve lesion. Three of the 5 patients were subjected to surgical treatment but the remaining 2 were treated by medication.

Results: All the 31 patients who had undergone surgical treatment recovered. Two of the 12 patients who had received medication died. Twenty-seven patients undergoing surgical treatment were followed up, and no death or recurrent endocarditis occurred. The life quality of the patients was improved markedly.

Conclusions: Similar clinical characteristics and echocardiographic manifestations of IE were noted in children and adults. Surgery is effective in the treatment of infective endocarditis, and the timing of surgery is crucial. Most children with IE have abnormalities of the heart or congenital heart disease. Hence, these patients should be treated early to avoid the occurrence of IE.