Bovine valve and risk of infection
- Thread starter bbb
- Start date
Help Support Valve Replacement Forums:
Good site about prosthetic heart valves:
http://emedicine.medscape.com/article/780702-overview
Sounds like, if I am interpreting this right, there is not a huge risk of endocarditis for people with prosthetic heart valves:
PVE (Prosthetic Valve Endocarditis) occurs in 2-4% of patients. The incidence is 3% in the first postoperative year, then 0.5% for subsequent years. The incidence is higher in mitral valves. Mechanical and biological valves are equally susceptible.
http://emedicine.medscape.com/article/780702-overview
Sounds like, if I am interpreting this right, there is not a huge risk of endocarditis for people with prosthetic heart valves:
PVE (Prosthetic Valve Endocarditis) occurs in 2-4% of patients. The incidence is 3% in the first postoperative year, then 0.5% for subsequent years. The incidence is higher in mitral valves. Mechanical and biological valves are equally susceptible.
Earlier you asked if you have to get blood cultures everytime you get a fever. We were told to get them if Justin had a fever /felt sick for a couple days. The only other time I remember having blood cultures done since (he had BE 10 years ago) he ended up having Mono. He did have blood cultures drawn when he had the infection in and under his sternum to see if it was in his blood stream, but it wasn't.
sue943
Well-known member
Just as a note to UK patients, expect to stay in hospital for the duration. I was in for almost six weeks and they injected me six times each 24 hours, so 2am included - no drip, just slow injections. I wasn't discharged until I was on oral antibiotics.
Yes and it answers some questions by listing the most common causes
of prosthetic valve endocarditis - such as;1)dental procedures, 2)Genito-
Urinary sources(I guess kidney/bladder infections), 3) G.I manipulation-
(maybe endoscopy), 4)I.V. drug abuse- but I have to wonder if this includes
anything given intravenously where sterile procedure is not followed(?).
Just some thoughts.
Thanks for the Info - Dina
Much of the statistical info following is paraphrased from http://emedicine.medscape.com/article/782264-overview and other sources:
Even with a replaced valve, the rate of endocarditis is low. It's higher for those who've already had it once, and those over 50 (rats!).
The prevalent rate overall in the US is 1.4-4.2 cases per 100,000 people per year, and described as similar in the other developed nations. So, at the highest estimate, this is equal to .0042cases per 100 people (.0042%). That's a tiny percentage. We see much higher rates on the valve replacement site because, well...this is where they wind up because their valves get replaced.
For those with replacement valves, 50% of the cases occur within 60 days, and are thus directly attributable to surgical and postsurgical care infection. So, if you're past 60 days from surgery, take the infection rates you've seen posted above, and cut them in half.
Interestingly, the male-to-Female ratio is 2-to-1. Say...maybe it's from lifting that toilet seat...
Me speaking:
Unless you have underlying immune system issues, your'e not likely to get endocaditis from food that's coated in foreign germs or has gone bad. You're not going to get it directly from a cold or flu (virus). You're not going to get it from waiting more than 30 seconds after an alcohol wipe before testing your blood for warfarin (you get far more germs from the kitchen sponge you pick up right after you test, or the doorknob, or the TV remote or...you get the idea). You can make yourself crazy looking for germ sources.
For decades, dentists have been getting a bum rap for causing IE, but it's often been a case of "well, he had dental work done only three/six months ago/earlier this year," and similar general attributions, even though 60 days is the generally accepted incubation. Since it was acknowledged that it could be caused by dental work, it's been handy to blame it for everything since.
General tooth and gum care is now deemed much more relevant to IE causation than dental work, because it keeps your gums healthy, which makes common punctures to the gums (you pierce them much more frequently than you realize while eating, flossing, and brushing your teeth) much freer of germs and reduces gum healing time. Also, poor mouth health makes dental work and cleanings more hazardous by definition.
So I say, brush and floss, wash your hands, and forget about it.
Even with a replaced valve, the rate of endocarditis is low. It's higher for those who've already had it once, and those over 50 (rats!).
The prevalent rate overall in the US is 1.4-4.2 cases per 100,000 people per year, and described as similar in the other developed nations. So, at the highest estimate, this is equal to .0042cases per 100 people (.0042%). That's a tiny percentage. We see much higher rates on the valve replacement site because, well...this is where they wind up because their valves get replaced.
For those with replacement valves, 50% of the cases occur within 60 days, and are thus directly attributable to surgical and postsurgical care infection. So, if you're past 60 days from surgery, take the infection rates you've seen posted above, and cut them in half.
Interestingly, the male-to-Female ratio is 2-to-1. Say...maybe it's from lifting that toilet seat...
Me speaking:
Unless you have underlying immune system issues, your'e not likely to get endocaditis from food that's coated in foreign germs or has gone bad. You're not going to get it directly from a cold or flu (virus). You're not going to get it from waiting more than 30 seconds after an alcohol wipe before testing your blood for warfarin (you get far more germs from the kitchen sponge you pick up right after you test, or the doorknob, or the TV remote or...you get the idea). You can make yourself crazy looking for germ sources.
For decades, dentists have been getting a bum rap for causing IE, but it's often been a case of "well, he had dental work done only three/six months ago/earlier this year," and similar general attributions, even though 60 days is the generally accepted incubation. Since it was acknowledged that it could be caused by dental work, it's been handy to blame it for everything since.
General tooth and gum care is now deemed much more relevant to IE causation than dental work, because it keeps your gums healthy, which makes common punctures to the gums (you pierce them much more frequently than you realize while eating, flossing, and brushing your teeth) much freer of germs and reduces gum healing time. Also, poor mouth health makes dental work and cleanings more hazardous by definition.
So I say, brush and floss, wash your hands, and forget about it.
The valve doesn't catch a cold type thing. The bacteria latches on to the surface valve and starts growing/multiplying and basically eating up the valve. Also clumps of the bacteria (vegitation) can break off and cause damage similar to blood clots
Thanks, Bob, for all the great facts. Knowing it is a pretty rare occurence is helpful, too. Brush, floss and forget about it...great advice!
I also just got back from seeing my GP and she emphasized, you don't get endocarditis from a cold or flu, BUT if you have something like that and continue to feel not right, get checked out. Good to know you can't get it from cold or flu.
Thanks, everyone, for all the helpful info.
Betsy
I also just got back from seeing my GP and she emphasized, you don't get endocarditis from a cold or flu, BUT if you have something like that and continue to feel not right, get checked out. Good to know you can't get it from cold or flu.
Thanks, everyone, for all the helpful info.
Betsy
SMS
Well-known member
When I was at CC, my surgeon stated the he didn't agree with the current American Heart Assoc. guidelines for antibiotics,and was going to submit that they go back to the way they were before 2007, which was ANY MVP or leaky valve patient was to take antibiotics before dental work.
In my case, 1 month after getting my teeth cleaned, I came down with Infective Endocarditis. Because of the current guidelines, I wasn't taking any antibiotics. Now I have a "wallet card" that says I have to.
Steve
In my case, 1 month after getting my teeth cleaned, I came down with Infective Endocarditis. Because of the current guidelines, I wasn't taking any antibiotics. Now I have a "wallet card" that says I have to.
Steve