Need for Antibiotics for other Surgeries?

[Smiley2000]

Hi there all VR-friends

I have been battling with Chronic Appendicitis for the past 6 years and after severe infection last week, my GP is referring me to a General Surgeon to get an opinion on removing it!

How will other surgeries affect me now? I am not on Warfarin or any anti-caughulants or actually not taking any medication, accept for 2 sets of antibiotics and painkillers. Am I at risk for Endocarditis at all? I am 17 months post-op, I had a Mitral Repair done, so I don't have anything Mechanical in me. Even when I go to the Dentist (had root cannal done yesterday) they don't give me antibiotics anymore (Cardio said I don't have MVP and thus don't need phrophylaxis).

Should I insist on Prophylaxis before this op?

 

[DarrinDNelson]

Hi there all VR-friends

I have been battling with Chronic Appendicitis for the past 6 years and after severe infection last week, my GP is referring me to a General Surgeon to get an opinion on removing it!

How will other surgeries affect me now? I am not on Warfarin or any anti-caughulants or actually not taking any medication, accept for 2 sets of antibiotics and painkillers. Am I at risk for Endocarditis at all? I am 17 months post-op, I had a Mitral Repair done, so I don't have anything Mechanical in me. Even when I go to the Dentist (had root cannal done yesterday) they don't give me antibiotics anymore (Cardio said I don't have MVP and thus don't need phrophylaxis).

Should I insist on Prophylaxis before this op?

Hi. My surgeon told me that I should pre-medicate even prior to dental procedures indefinitely due to being an Endocarditis risk after my recent MV Repair.

I would ask your surgeon.

 

[netmiff]

I would ask your cardio, but if you don't need antibiotics for the dentist, my gut is saying he will say no.

 

[Lynlw]

I would also ask your cardio just to be safe. I do have a question tho, don't you have a ring with your repair? I know they are pretty routine.

IF it helps here are the (short version) guidelines http://www.americanheart.org/presenter.jhtml?identifier=11086
And here are the parts about GI procedure (altho I'm not sure what qualifies as a procedure)

...The American Heart Association’s Endocarditis Committee, together with national and international experts on BE, extensively reviewed published studies to determine whether dental, gastrointestinal (GI) or genitourinary (GU) tract procedures are possible causes of BE. These experts determined that no conclusive evidence links dental, GI or GU tract procedures with the development of BE....

...Gastrointestinal/Genitourinary Procedures: Antibiotic prophylaxis solely to prevent BE is no longer recommended for patients who undergo a GI or GU tract procedure, including patients with the highest risk of adverse outcomes due to BE...

 

[Smiley2000]

I would also ask your cardio just to be safe. I do have a question tho, don't you have a ring with your repair? I know they are pretty routine.

IF it helps here are the (short version) guidelines http://www.americanheart.org/presenter.jhtml?identifier=11086
And here are the parts about GI procedure (altho I'm not sure what qualifies as a procedure)

...The American Heart Association’s Endocarditis Committee, together with national and international experts on BE, extensively reviewed published studies to determine whether dental, gastrointestinal (GI) or genitourinary (GU) tract procedures are possible causes of BE. These experts determined that no conclusive evidence links dental, GI or GU tract procedures with the development of BE....

...Gastrointestinal/Genitourinary Procedures: Antibiotic prophylaxis solely to prevent BE is no longer recommended for patients who undergo a GI or GU tract procedure, including patients with the highest risk of adverse outcomes due to BE...

Thank you all for replying.

Yes, I have an Annuluplasty ring around my Mitral valve. I also think that the prophylaxis is not necessary. I am going to just make a note of it for the Surgeon, but even when they surgically removed a vasculitis from my leg Sept. 2008 I got an IV antibiotics before and after the procedure. Sure the guy was just being cautious. Rather save than sorry!

 

[Smiley2000]

Thanks for all the trouble you went through with the quote and link, etc. Greatly appreciate it.

 

[Lynlw]

Thank you all for replying.

Yes, I have an Annuluplasty ring around my Mitral valve. I also think that the prophylaxis is not necessary. I am going to just make a note of it for the Surgeon, but even when they surgically removed a vasculitis from my leg Sept. 2008 I got an IV antibiotics before and after the procedure. Sure the guy was just being cautious. Rather save than sorry!

I'm pretty sure the ring for the repair counts the same as a valve as far as dental procedures

...Therefore, Class IIa indications for prophylaxis against infective endocarditis are reasonable for VHD patients at highest risk for adverse outcomes from infective endocarditis before dental procedures that involve manipulation of either gingival tissue. This high-risk group includes: 1) patients with a prosthetic heart valve or prosthetic material used for valve repair, 2) patients with a past history of infective endocarditis, and 3) patients with cardiac valvulopathy after cardiac transplantation, as well as 4) specific patients with CHD (Table 2). ...
http://circ.ahajournals.org/cgi/content/full/118/8/887