Antibiotics

I have 3 to 4+ aortic insufficiency, and I will be having a pap smear and an endocervical scraping performed because of an abnormal pap smear  and my cardiologists said that I should take an antiobiotic before this procedure.  My gyne was somewhat upset and said that according to AHA standards, I do not need antibiotics for this procedure because it is only a scraping.

I have been on antibiotics several times for dental procedures, colonoscopy, gastro,  during the past three months, and if I really don't need to be on antibiotics for this procedure, I would rather not. I think my gyne is concerned because he feels the same as I do. Too many antibiotics in a short period. He says the scraping may cause only very, very minor discharge. Also, if the scraping is abnormal, I may need a surgical procedure shortly after called a cone biopsy which is under anesthetic and will definitely require antiobiocs.

I get confused when two doctors have two strongly differing opinions.  Also, my gyne and cardiologist tell me that if I have to go under anesthesia, even though I have moderate to severe leakage, this should pose no problem to my heart?  Do you agree?  What precautions should be taken?

Also, please answer one (or two) more questions.  When you say that when mechanical valves fail it is catastrophic, do you instantly die, or does it give advance warning that it is failing like a tissue valve does?  Why does it fail?  Should this be a major deciding factor in choosing a valve?


I know I have many questions, and I thank you for all of the information you provide.  I feel rushed when I visit my cardiologists and sometimes feel I'm taking too much of their time if I have too many questions. I want you to know that I have heard nothing but wonderful comments about the cardiologists at Cleveland Clinic.  Not only because of your expertise, but because of your kind, caring manner.  That is so important, because all of this is overwhelmingly scary to me, and I know it is to other people also. It seems that when something is seriously wrong with your heart, it affects your body and soul.

Again, thank you for taking time from your busy schedules to provide this wonderful forum. (Sorry this is so long, it won't happen again!)

[Cleveland Clinic, MD]

There is a divergence of opinions concerning antibiotic prophylaxsis.  The new AHA guideline do not recommend antibiotics for cervical biopsy but not all doctors will necessarily agree or adhere to these suggested guidelines.

Given your valve condition you are at increased risk for surgical procedures but this should not be a big problem.

Most mechanical valves have very long lives - usually longer than the person.  However, if they fail it is gradually and with warning.