Antibiotic prophylaxis against infective endocarditis is recommended before a dental extraction in which of the following patients?
- A A 66-year-old woman with a bioprosthetic mitral valve replacement performed four years ago ✓
- B A 34-year-old man with mitral valve prolapse and mild mitral regurgitation
- C A 70-year-old man who underwent coronary artery bypass grafting five years ago
- D A 25-year-old woman with a transcatheter-closed secundum atrial septal defect placed eight months ago
Correct answer: A. A 66-year-old woman with a bioprosthetic mitral valve replacement performed four years ago
Explanation
Cardiac conditions for which endocarditis prophylaxis is advised before dental procedures are prosthetic cardiac valves (mechanical or bioprosthetic), a previous episode of infective endocarditis, certain unrepaired or recently repaired cyanotic congenital defects, and valve regurgitation in a cardiac transplant recipient. Mitral valve prolapse, prior bypass grafting and a successfully closed atrial septal defect beyond six months do not require prophylaxis under ACC/AHA guidance.
Reference: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 12th ed.
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Written and medically reviewed by the StethoPrep medical team.