講演情報
[I-AEPCJS-4]What have we learned - Changes in international guidelines of infective endocarditis
○Walter Knirsch1,2 (1.Pediatric Cardiology and Children’s Research Center, University Children's Hospital Zurich, Switzerland, 2.University of Zurich, Switzerland)
キーワード：
Infective endocarditis、Congenital Heart Disease、Prevention
Guidelines of the prevention of infective endocarditis (IE) have been developed within the last decades, also including patients with congenital heart disease at risk of IE. The rationale of prevention of infective endocarditis includes predisposing risk factors such as (1) the anatomical substrate with endocardial lesions, (2) pathogens entering the blood stream, and (3) the immune response. In 2007, international guidelines (ESC/AHA) limited antibiotic prophylaxis for patients at high risk of IE and for high-risk dental procedures. Since 2023, prevention of infective endocarditis focus on patients at high risk depending on the type of endocardial lesions, which is highly associated with patients with prosthetic valve replacement, unrepaired cyanotic congenital heart disease, and palliative shunts/conduits, or after IE. In this patients at high risk of IE periprocedural antibiotic prophylaxis is recommended in oro-dental procedures. Nevertheless, prevention measures in daily life are a matter of concern including twice daily tooth cleaning, follow-up at least twice yearly professional dental cleaning, strict cutaneous hygiene (disinfection of wounds, treatment of chronic skin conditions), discouragement of piercing and tattooing. Patient education may enhance the awareness of symptoms of IE. In conclusion, changes in international guidelines of IE have been continuously made with adaptations of risk groups and risk procedures.