Cardiologia Ospedale San Vincenzo - Taormina (Me) Azienda Sanitaria Provinciale di Messina, Contrada Sirina, 98039, Taormina, Messina, Italy,
J Cardiovasc Transl Res. 2014 Apr;7(3):372-4. doi: 10.1007/s12265-014-9553-9. Epub 2014 Feb 25.
Heart valve repair or replacement is a serious problem. Patients can benefit from an open dialogue between both cardiologists and gastroenterologists for the optimal effective patients care. The focused update on infective endocarditis of the American College of Cardiology/American Heart Association 2008 (ACC/AHA guidelines) and guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) of the European Society of Cardiology (ESC guidelines) describe prophylaxis against infective endocarditis (IE) as not recommended for gastroscopy and colonoscopy in the absence of active infection but increasing evidence suggests that the role of IE antibiotic prophylaxis remains a dark side of the cardio-oncology prevention. New evidences concerning infective endocarditis due to Streptococcus bovis, Streptococcus agalactiae, Enterococcus faecalis, Enterococcus faecium, Enterococcus durans, and new findings indicate that there is a need for bacterial endocarditis prophylaxis in patients undergoing gastrointestinal endoscopy especially in elderly patients and in cancer and immunocompromised patients, to avoid serious consequences.
心脏瓣膜修复或置换是一个严重的问题。为了使患者得到最佳的治疗效果，心内科医生和消化科医生之间需要进行开诚布公的对话。美国心脏病学会/美国心脏协会 2008 年（ACC/AHA 指南）关于感染性心内膜炎的重点更新，以及欧洲心脏病学会（ESC 指南）关于感染性心内膜炎预防、诊断和治疗的指南（2009 年新版），均描述了在无活动性感染的情况下，不建议预防性使用抗生素来预防感染性心内膜炎（IE），但越来越多的证据表明，IE 抗生素预防的作用仍然是心血管肿瘤预防的一个阴暗面。由于牛链球菌、无乳链球菌、粪肠球菌、屎肠球菌、耐久肠球菌引起的感染性心内膜炎的新证据表明，有必要对接受胃肠内镜检查的患者进行细菌心内膜炎预防，尤其是老年患者、癌症和免疫功能低下的患者，以避免严重后果。
