Re: Surgical Prophylaxis for MVP
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Tue Sep 19 12:29:59 2006
There are AHA guidelines from 2001, I think, and MVP without murmur is
not a lesion requiring prophylaxis for endocarditis.
Ancef is appropriate for the surgical site, of course.
Garry
At Tue, 19 Sep 2006, ainsron wrote:
>
>That is not correct, prophylaxis is indicated for TAH or Vag Hys, per ACOG
>guidelines for surgical site infections - endocarditis prophylaxis is
>another issue. It is not recommended for laparoscopy.
>
>Ronald E. Ainsworth, MD, FACOG
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Kim Elise
>Goldman
>Sent: Tuesday, September 19, 2006 5:18 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Surgical Prophylaxis for MVP
>
>PS Abdominal surgery without entry into the aerodigestive tract is
>not an indication for endocarditis prophylaxis per AHA guidelines.
>(EG vag hyst indicated for prophylaxis but TAH probably not indicated.)
>
>Kim
>
>On Sep 19, 2006, at 7:44 AM, Joanne Bulley, MD wrote:
>
>> Hi folks,
>>
>> With a fair number of women who have MVP - without arrhythmia and with
>> the subtlest of murmur - when doing a TAH (or other hyst) would you
>>
>> a) standard prophylaxis with cefazolin (Ancef)
>>
>> b) MVP / lower cardiac risk prophylaxis with ampicillin?
>>
>> My hospital pre-printed orders for the cardiac prophylaxis suggests
>> just
>> Ampicillin. But it also suggests it is needed for MVP only if
>> there is
>> regurg or thickened leaflets.
>>
>> Many of these women have not told me about the MVP - and it comes up
>> when the pre-op RN at the hospital asks the question and then who
>> knows
>> where the echocardiogram (if any) was done - and I get the phone call
>> "she needs prophylaxis for MVP"
>>
>> What do you do in your institution? (I am always curious about how
>> folks
>> do things in different places around the globe - as there are so many
>> variations because a lot of what we do does not have "final" EBM
>> answers.)
>>
>> --
>> Joanne Bulley, MD
>> Keene, NH, USA
>>
--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
