Small PFO...do I need antibiotics before dental work?

[snfr02chic]

I was diagnosed with a small PFO several years ago. I take an aspirin a day, and it's about time for me to have dental work done. Even if my PFO is small, do I still need antibiotics to prevent a possible bacterial infection? Thanks!

[kenkeith]

I understand the concern of blood getting into the system that hasn't been filtered by the lungs, however,

My soruce is Cleveland Clinic:
"Patients with a patent foramen ovale are not at an increased risk of endocarditis and antibiotic prophylaxis is not indicated. For those who have had their PFO closed with a transcatheter device, endocarditis prevention is recommended for at least 6 months following the device implant. According to the American Heart Association, after 6 months, there is insufficient data to make recommendations for prophylactic therapy"

Emedicine: 2009
•Dental procedure prophylaxis concerns are as follows:
◦Recently, a retrospective study was performed that questioned the use of antibiotic prophylaxis prior to dental work.
◦The only dental procedure with an increased risk of endocarditis was tooth extraction within 2 months after hospitalization.
•Patients with a history of valve abnormalities who were given antibiotics were not protected against endocarditis.

Hope this helps.  Take care.
.

[snfr02chic]

My blood does normally shunt, on a regular basis..each test that I've had has shown blood shunting R-L. My concern is that if I have R-L shunting as my baseline, isn't it probable that bacteria could also be included in that? I've very familiar with anatomy, I work in a Cardiac ICU, but this is not something that gets brought up on a normal basis.

[kenkeith]

A small PFO shouldn't cause any problems.   All that happens is a small amount of blood is shunted from left atrium (oxygenated blood) to the right atrium blood to go to the lungs to get oxygenated. However, there are circumstances where the pressure on the right side is greater than the left side so there is a possibility a clot can pass to left side causing a stroke.

Individuals with a patent foramen ovale are not at an increased risk of endocarditis and antibiotic prophylaxis is not indicated and that includes dental procedures.

Hope this helps, and thanks for your question if you have any further questions, you are welcome to respond.
Take care.