A 45-year-old woman with a bicuspid aortic valve (no stenosis or regurgitation) and mitral valve prolapse (no regurgitation) is scheduled for dental extraction. According to current AHA guidelines, which patients should receive infective endocarditis prophylaxis?
- A All patients with bicuspid aortic valve undergoing dental procedures
- B Only patients with prosthetic valves, prior IE, unrepaired cyanotic CHD, or cardiac transplant with valvulopathy ✓
- C All patients with any structural valve abnormality
- D Only patients with mechanical prosthetic valves
Correct answer: B. Only patients with prosthetic valves, prior IE, unrepaired cyanotic CHD, or cardiac transplant with valvulopathy
Explanation
AHA guidelines restrict IE prophylaxis to high-risk groups: prosthetic valves, prior IE, unrepaired cyanotic CHD, repaired CHD with residual defects at the site of patch, and cardiac transplant recipients with valve regurgitation due to structurally abnormal valves. Bicuspid AV without hemodynamic significance and MVP without regurgitation do NOT warrant prophylaxis.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.