VSD w/BE - need correcting?

I am 31 with an unrepaired congenital VSD and was diagnosed 2 wks ago with BE.  Diagnosis came after suffering a stroke.  Other symptoms were vague (fever, loss of appetite, exhaustion)and were masked by pregnancy - 29 wks pregnant at diagnosis with BE.  I am currently being treated with IV antibiotic at home.  There seems to be differing opinion as to the need to correct my VSD now that I have BE.  I have heard to correct now (surgery several months after delivery) and some have said that I wait until I get BE for the 2nd time.  Is there a general philosophy?  Does the stroke affect the opinion?  After someone gets BE for the 1st time, how increased are their chances to get it again?  Is open heart surgery still the only way to correct VSD or are there options?  VSD has been without symptoms or any complications until this point.  Other than pre-med for procedures, is there any way to prevent BE in the future?

[CCF-M.D.-RCJ]

JJB530,

Thanks for the interesting post, and sorry to hear of your very complicated ordeal.  I hope BE means Bacterial Endocarditis, and not Barium Enema!

First, you need a coordinated (surgical, medical, and neurologic) opinion from a major center.  There simply is no guideline for how to deal with the VSD, pregnant, endocarditis patient with a stroke!

I think that the stroke pushes strongly for repair, but the timing will be tricky with the pregnancy and infection.  The first episode of endocarditis certainly argues that a second episode is more likely, but I can't give you numbers for this.  Open heart surgery is still the only option for repair.

Please seek care at a major medical center.

Good luck