Supravalvular Ring Mitral Stenosis Guidelines

Updated: Dec 15, 2020
  • Author: Michael D Pettersen, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
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Guidelines Summary

Prophylaxis against infective endocarditis (IE) 

The 2014 AHA/ACC guidelelines for managment of valvular diseases recommend (Class IIa) prophylaxis against infective endocarditis (IE) before dental procedures that involve manipulation of gingival tissue, manipulation of the periapical region of teeth, or perforation of the oral mucosa for patients at highest risk for adverse outcomes from IE including [15]

  • Patients with prosthetic cardiac valves
  • Patients with previous IE
  • Cardiac transplant recipients with valve regurgitation due to a structurally abnormal valve
  • Patients with unrepaired cyanotic CHD, including palliative shunts and conduits
  • Patients with congenital heart disease (CHD) with completely repaired congenital heart defect repaired with prosthetic material or device, whether placed by surgery or catheter intervention, during the first 6 months after the procedure
  • Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device. 

Prophylaxis against IE is not recommended for nondental procedures (e.g., TEE, esophagogastroduodenoscopy, colonoscopy, or cystoscopy) in the absence of active infection (Class III)

The indication for antibiotic prophylaxis for endocarditis has also been significantly reduced in the 2012 European Society of Cardiology /European Association for Cardio-Thoracic Surgery (ESC/EACTS) guidelines for managment of valvular diseases, although they recommend considering antibiotic prophylaxis for high-risk procedures in high-risk patients. [15]