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Individuals with congenital heart disease (CHD) may be at increased risk of developing an infection inside the heart. There is greatest risk in those with chronic cyanotic heart conditions and/or pulmonary hypertension/Eisenmenger's syndrome. Other congenital conditions that remain at risk are those with residual defects causing turbulent blood flow through heart chambers and/or areas of surgical repair with artificial materials such as patches or valve placements.
Extensive review of research by the American Heart Association's Endocarditis Committee and international experts developed new guidelines for prevention of bacterial endocarditis in 2007. The new guidelines have also been endorsed by the Infectious Diseases Society of America, the Pediatric Infectious Disease Society, and the American Dental Association.
Previously all people with CHD received antibiotics before dental and invasive procedures to prevent endocarditis. The new guidelines, however, require antibiotics prior to dental procedures only for cardiac conditions associated with the highest risk of complications from endocarditis. You will need to discuss your child's congenital conditions with his/her doctor to determine if your child needs antibiotic prevention.
Note that antibiotic prophylaxis may change if your child has more surgery or any new concern with his/her heart condition. Some of the simple patch or valve repairs only require antibiotics for the first six months after surgery until the artificial material undergoes endothelialization, a process in which natural tissue grows over the artificial material and makes it smooth.
Antibiotic prophylaxis is now recommended only for the following cardiac conditions:
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Bacterial Endocarditis
