Are All Ventricular Septal Defects Created Equal?

作者：Lax Daniela^*; Bhatt Rajan D; Klewer Scott E; Sorrell Vincent L

来源：Journal of the American Society of Echocardiography, 2010, 23(7): 791.e5.

DOI：10.1016/j.echo.2009.12.004

• Ventricular septal defect
• Endocarditis
• Left ventricular-to-right atrial shunt
• Gerbode defect

The authors report the occurrence of infective endocarditis in a 32-year-old man with a ventricular septal defect and a left ventricular-to-right-atrial shunt who adhered to the revised 2007 American Heart Association guidelines for infective endocarditis. The patient had received antibiotic prophylaxis prior to multiple previous dental procedures. At a recent dental evaluation for fillings, he was informed that he no longer needed prophylaxis. Fatigue and fevers developed 1 week later, and he was treated with an oral course of ciprofloxacin. The symptoms recurred, and blood cultures grew Streptococcus viridans. A 7-mm vegetative mass was seen on the septal leaflet of the tricuspid valve during transesophageal echocardiography. This report raises the concern that patients with ventricular septal defects and left ventricular-to-right-atrial shunts are at higher risk for endocarditis and may require antibiotic prophylaxis. (J Am Soc Echocardiogr 2010;23:791.e5-791.e7.)

• 出版日期2010-7