How do you prevent endocarditis and blood infections?

[csigabiga]

Hi all,

I am 6 weeks and 3 days post op where I replaced my native aortic valve and part of the aorta with a St Jude mechanical and graft. I am recovering very well and starting to think about how to preserve my new valve. This forum has been a wealth of helpful information so I thought I'd ask:

What precautions do you take in order to prevent endocarditis and blood infections?

I'm particularly wondering how people disinfect their toothbrushes, razor blades and what people do if and when they get a cut on their skin. Also if I missed anything, what else should be done?

Right now I've got a sonic care toothbrush and make sure to floss and mouthwash. I also visit the dental hygienist twice a year, taking amoxicillin before these visits.

Any other tips would be most appreciated. Thanks in advance!

 

[jeffp]

Hi all,

I am 6 weeks and 3 days post op where I replaced my native aortic valve and part of the aorta with a St Jude mechanical and graft. I am recovering very well and starting to think about how to preserve my new valve. This forum has been a wealth of helpful information so I thought I'd ask:

What precautions do you take in order to prevent endocarditis and blood infections?

I'm particularly wondering how people disinfect their toothbrushes, razor blades and what people do if and when they get a cut on their skin. Also if I missed anything, what else should be done?

Right now I've got a sonic care toothbrush and make sure to floss and mouthwash. I also visit the dental hygienist twice a year, taking amoxicillin before these visits.

Any other tips would be most appreciated. Thanks in advance!

First off, try to get your overall health as good as possible.

Keep up the proper dental care and prophylactic antibiotics. The SoniCare toothbrush does a good job and is not rough on the gums. Don’t floss so aggressively that there’s bleeding.

As to everyday cuts and such (I get lots of them doing construction and such), the usual wound cleansing and dressing does fine. If its deep enough to need stitches, take your antibiotics.

You really shouldn’t need to tip toe around for the rest of your life. Chain saws still get a lot of respect (as they did prior to valve replacement). I recommend against juggling them as a hobby or avocation.

 

[Timmay]

I’ll second the good oral hygiene. It’s really important. Use a soft toothbrush. Don’t muscle it … let the toothbrush do the work. Floss at least a few times a week (strive for every day). I always rinse my mouth out with Listerine after flossing.

I haven’t really done anything different except the recommended antibiotics before going to the dentist.

 

[KyleR]

Great to hear your recovery is going well. I had my aortic valve replaced in 2015 and came down with a bout of endocarditis on 2018. It was not a fun experience and wouldn’t wish it on anyone. Fortunately I was able to get through it without another operation. The most likely cause was a dental cleaning even though I took the antibiotic beforehand, so I just chalk it up to really bad luck. Like the others have said oral hygiene is key. I use Listerine every time before I brush my teeth rather than after to kill bacteria before brushing. No idea if there’s any evidence that this helps prevent infection but my cardiologist suggested it saying it couldn’t hurt. Good oral and general hygiene along with treating any cuts is really about all you can do. Endocarditis can happen but it’s still not very common so I would do what you can and try not to worry about it too much. One suggestion I would have though is to be very aware of the symptoms…general malaise, fever, night sweats. I brushed it off as just an illness at first and even went to urgent care twice and they said the same thing. Finally I called my cardiologist at the insistence of my wife and he admitted me to the hospital right away since these were apparently textbook symptoms. If you’re unlucky to get it early treatment is very important. Best of luck with your recovery!

 

[LondonAndy]

All sounds good, Daniel. I was advised to have my teeth cleaned quarterly. Otherwise no other particular measures taken.

 

[dick0236]

You really shouldn’t need to tip toe around for the rest of your life. Chain saws still get a lot of respect (as they did prior to valve replacement). I recommend against juggling them as a hobby or avocation.

I agree with Jeffp., you cannot "tip toe" around a lot of things you may encounter while living a normal life. Using common sense is the best we can hope to do in living our lives with our brand new valves.

FWIW, I was given no advice about dental care when I had the surgery in the 1960s and like many young men of that time I didn't give much thought about good dental hygiene.......and was lucky for twenty, or so, years before dental hygiene became a concern for valve patients........and I made it. We need not be carried around on a pillow to protect us from what life throws at us...........after all, you may get hit by a bus tomorrow.

 

[csigabiga]

Thanks to everyone. I have no intentions of tip toeing, but do plan on being cautious when it makes sense to, and it's of little effort to do so.

Sounds like I'm on the right track with dental hygiene, I'm just curious about how you guys treat cuts

the usual wound cleansing and dressing does fine

If you get a minor cut, do you clean it with hydrogen peroxide or iodine and then bandage? I've never bothered (or had reason to bother) with this before, but might start now.

treating any cuts

Same question as above.

I'm also curious if anyone does anything with razorblades. I've seen a few posts where people have mentioned soaking them (and toothbrushes) in alcohol between uses.

 

[LondonAndy]

Personally, I have not changed how I treat cuts, how I use a toothbrush or razor since getting a replacement heart valve. For minor cuts this may well mean no ointment of any description applied. I change my toothbrush every 3 months, and I prefer my alcohol in a glass.

 

[Timmay]

I converted to an electric razor before surgery because I wasn’t very well educated. If I had been educated better, I wouldn’t have. That said - I’m actually extremely happy with using an electric razor because I appreciate how quick it is. No more lathering the face and neck … no more buying shaving cream … no more blades … I’m loving the simplicity and time savings.

In addition to what I said above, my cardiologist actually wrote me a prescription for Amoxicillin so that I can have it on hand and use it when I need it. I haven’t used it yet except for teeth cleanings. I do NOT get teeth cleanings quarterly. Here in the USA we do it twice a year (generally).

As far as cuts, I haven’t changed anything actually. Some cuts I pay attention to and some I don’t. I literally do the same as I did before. Why? Because some cuts require assistance and some don’t. Why else? Because I’m.a desk worker. Thus, I have a lower risk of getting infections compared to construction people who will get a cut while working in the dirt and just keeping on with their day. I am not in that position so I haven’t had to change anything. I am saying this because I specifically know carpenters that will get cut and then just stuff the cut with saw dust … and run some duct tape around it.

 

[jeffp]

I'm just curious about how you guys treat cuts

soap and water, followed by an appropriate dressing; gauze or Band-aid, maybe some pressure. Peroxide and iodine have their use but damage the wound edge tissue and slow healing. Clean wounds heal the best. Nothing to do with “valviness”.

You’re overthinking it. Go live the extra years the valve allows you to have.

 

[mecretired]

I had surgery to replace my aortic root, aortic valve an ascending aorta 13 yrs ago. I’ve had endocarditis twice—2019 and 2020. Mine was strep. Infectious disease Dr said almost all strep comes from the mouth. I had absolutely no teeth or gum problems. Couple of tips I picked up—use antiseptic mouthwash before brushing your teeth and I use a waterpik rather than flossing. I’ve also been on 2x day cephalexin for almost 3 yrs. Best of luck to you.

 

[KyleR]

Thanks to everyone. I have no intentions of tip toeing, but do plan on being cautious when it makes sense to, and it's of little effort to do so.

Sounds like I'm on the right track with dental hygiene, I'm just curious about how you guys treat cuts



If you get a minor cut, do you clean it with hydrogen peroxide or iodine and then bandage? I've never bothered (or had reason to bother) with this before, but might start now.




Same question as above.

I'm also curious if anyone does anything with razorblades. I've seen a few posts where people have mentioned soaking them (and toothbrushes) in alcohol between uses.

I just treat with soap or hydrogen peroxide, Neosporin and bandage. It is my (possibly incorrect) understanding that it would probably take a deep cut for bacteria to get directly into the bloodstream that could potentially latch onto the valve and cause endocarditis. I don't think superficial cuts from shaving or from a minor scratch are much to worry about, but best to clean and treat them to be on the safe side.

 

[KyleR]

I had surgery to replace my aortic root, aortic valve an ascending aorta 13 yrs ago. I’ve had endocarditis twice—2019 and 2020. Mine was strep. Infectious disease Dr said almost all strep comes from the mouth. I had absolutely no teeth or gum problems. Couple of tips I picked up—use antiseptic mouthwash before brushing your teeth and I use a waterpik rather than flossing. I’ve also been on 2x day cephalexin for almost 3 yrs. Best of luck to you.

Sorry to hear that, that's a run of bad luck. It sounds like they were able to address it without another operation?

 

[pellicle]

What precautions do you take in order to prevent endocarditis and blood infections?

the primary source of entry is the mouth. So good oral hygiene is the main issue. This means scrupulous cleaning and perhaps at least yearly dental inspections and subgingival cleans. When doing that ensure antibiotic cover.

The other 5% or so is beyond control.

 

[pellicle]

If you get a minor cut, do you clean it with hydrogen peroxide or iodine and then bandage? I've never bothered (or had reason to bother) with this before, but might start now.

you won't get it from a scratch ... think about this logically (not with your axles up on a hoist spinning the wheels worrying in indistinct and general ways).

How close is your finger to your heart? Now, how close is your mouth to your heart? Which one has a soft much liquid all around it all the time filled with a huge variety of bacteria? Unless you work in a sewerage plant it'll be your mouth
https://www.news-medical.net/health...streptococcus, Treponema, Actinomyces genera.
If people step back when you talk then that's a good indication that your oral flora is going well towards killing you via endo.

to directly answer your question I follow basic stuff ... I may just tip a bit of metho on it or if its more serious may clean it (sponge fresh water and some mild detergent) then swab it with betadine then cover it with something and get back to work.

HTH

 

[carolinemc]

Hi all,

I am 6 weeks and 3 days post op where I replaced my native aortic valve and part of the aorta with a St Jude mechanical and graft. I am recovering very well and starting to think about how to preserve my new valve. This forum has been a wealth of helpful information so I thought I'd ask:

What precautions do you take in order to prevent endocarditis and blood infections?

I'm particularly wondering how people disinfect their toothbrushes, razor blades and what people do if and when they get a cut on their skin. Also if I missed anything, what else should be done?

Right now I've got a sonic care toothbrush and make sure to floss and mouthwash. I also visit the dental hygienist twice a year, taking amoxicillin before these visits.

Any other tips would be most appreciated. Thanks in advance!

You cannot totally prevent infection from going down to the heart, for colds, mouth infections, and other viruses can cause endocarditis. No matter how clean toothbrushes are you can still get a virus from a cold, flu, and other types of i viruses. So sorry to tell you the hard truth. And you can have a bad tooth where the infection can go to the heart.

 

[pellicle]

I am 6 weeks and 3 days post op where I replaced my native aortic valve and part of the aorta with a St Jude mechanical and graft. I am recovering very well

oh, meant to add: excellent stuff, keep up the walking and keep to the principle of small advances ever day, don't over do it and set yourself back. Slow and steady wins this race.

FWIW mech is a bit less likely to get endo anyway and don't consider dental anything until well after 3 months. Especially a "scale and clean".

some prior posts of mine:
https://www.valvereplacement.org/threads/day-14-after-surgery.888685/#post-918771
https://www.valvereplacement.org/th...leaning-precautions.888088/page-2#post-907116
https://www.valvereplacement.org/threads/endocarditis—again.887634/#post-899127

Best Wishes

 

[mecretired]

Sorry to hear that, that's a run of bad luck. It sounds like they were able to address it without another operation?

Yes, thank you. Spent a week in the hospital both times. Went home with a pic line both times to do daily antibiotic injections.

 

[oo0My_Valve0oo]

About flossing, the more you floss the less problems you have with flossing. People who don't floss routinely often think flossing causes gums to bleed. It is NOT flossing which leads to bleeding gums. Also you should floss a minimum of twice a day everyday. Even if you have not eaten food flossing oxygenates the gums which is good and contributes to healthy gums. Of course be gentle. You certainly can cut and separate gum from teeth and bone by going at it with reckless abandon. You can also strengthen gums by gently brushing teeth without toothpaste (massaging your teeth and gums sort of like chewing on a toothbrush) while watching television or reading. This, according to the best dentist ever to have existed.

 

[tom in MO]

You should wash and clean a wound irrespective of heart valve problems. A coworker got a blood borne infection from a scrape on a gym floor after a fall. He was in the hospital in <24 hours and stayed for several days due to an infection from the scrape.

We had a woman on the forum who got endocarditis pretty bad. Her infectious disease specialist recommended a good rinse with an antibiotic mouthwash before any dental procedure as a general preventive measure. I mentioned it to my dentist and he agreed. So I rinse well with Listerine about 15-30 min before my appointment and his staff have me rinse with a prescription mouth wash immediately before they begin. You won't find any papers on it but it makes sense, there is no risk in mouthwash and at least two medical professionals agree.