ENDOCARDITIS PROPHYLAXIS

CLASS IIa
(1) Prophylaxis against infective endocarditis is reasonable for the following patients at highest risk for adverse outcomes from infective endocarditis who undergo dental procedures that involve manipulation of either gingival tissue or the periapical region of teeth or perforation of the oral mucosa:
●Patients with prosthetic cardiac valve or prosthetic material used for cardiac valve repair.
● Patients with previous infective endocarditis.
● Patients with CHD.
● Unrepaired cyanotic CHD, including palliative shunts and conduits.
● Completely repaired congenital heart defect repaired with prosthetic material or device, whether placed by surgery or by 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 (both of which inhibit endothelialization).
● Cardiac transplant recipients with valve regurgitation due to a structurally abnormal valve.

CLASS III
(1) Prophylaxis against infective endocarditis is not recommended for nondental procedures (such as transesophageal echocardiogram, esophagogastroduodenoscopy, or colonoscopy) in the absence of active infection.




JACC Vol. 52, No. 13, 2008
September 23, 2008: e1-142