People who have damaged, repaired or replaced heart valves are at increased risk for developing an infection of the valve (endocarditis). Until recently, the American Heart Association recommended giving antibiotics to prevent endocarditis to these patients before they had dental work. However, those guidelines have changed — the American Heart Association no longer recommends antibiotics before dental procedures, except for patients at the highest risk for bad outcomes from endocarditis, including:

• those with prosthetic heart valves
• patients who have had endocarditis in the past
• patients with certain types of congenital heart defects, and
• heart-transplant patients who develop a problem with a heart valve.

For all people with prosthetic heart valves, it’s very important to receive antibiotics before certain types of dental work involving the gum tissues, teeth or other soft tissues inside the mouth. This includes routine professional cleaning.

If a person has had heart valve surgery, but has not had a heart valve replaced, their cardiologist or surgeon will tell them if they need antibiotics.

The American Heart Association no longer recommends antibiotics to prevent IE in patients who have gastrointestinal tract or genitourinary tract procedures..

People who have had heart valve surgery will probably be placed on an anticoagulant to prevent blood clots from forming.

The American Heart Association does not conduct technical review of mechanical heart valves. The U.S. Food and Drug Administration is the agency empowered to make determinations when such products come under question.

Related AHA publications:

• Your Heart Valve Surgery