Dental, Endocarditis, Surgical Valve Replacement
Conditions
Brief summary
In Odense University Hospital preoperative dental screening (PDS) protocol for patients treated with surgical valve replacement was changed from mandatory to targeted PDS to from march 2024. The investigators will therefore compare the risk of IE before vs after march 2024.
Detailed description
Infective endocarditis (IE), a condition linked with significant mortality and morbidity rates, is particularly concerning for patients with prosthetic left-sided valves. These patients face an elevated IE risk, estimated at about 1% annually in tertiary care settings, cumulatively impacting around one in every 20 patients over a decade. In line with this, both the American Heart Association (AHA) and the European Society of Cardiology (ESC) strongly advocate for the elimination of potential dental sepsis sources at least two weeks before prosthetic valve implantation, except in urgent cases. These guidelines, while not grounded in randomized trials, largely draw upon registry data detailing IE incidence among surgical valve replacement patients. In a recent study the investigators found no difference in risk of IE when comparing mandatory preoperative dental screening (MPDS) with no preoperative dental screening (NPDS). Thus, this prospective registry-based observational before-and-after study aims to investigate the impact of different preoperative dental screening practices on the risk of IE in patients undergoing.
Interventions
PROCEDURENo preoperative dental screening
Discontinuance of mandatory preoperative dental screening prior surgical valve replacement which also can include oral surgery.
Sponsors
Odense University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing surgical valve replacement
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants with Infectious Endocarditis | Through study completion, an average of 1 year | Infectious endocarditis diagnosed by healthcare professionals |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants undergoing Tooth extraction at dental screening | Through study completion, an average of 1 year | Number of Tooth extraction procedure performed in patients as part of the dental screening |
| The different Bacteria types causing the infectious endocarditis assessed by blood culture | Through study completion, an average of 1 year | Reporting all the different bacteria type causing infectious endocarditis, including the rate of each bacteria. |
| Number of Participants undergoing Oral surgical procedure at dental screening | Through study completion, an average of 1 year | Number of oral surgical procedure performed in patients as part of the dental screening |
| Number of Participants with IE caused by bacteria from oral foci | Through study completion, an average of 1 year | Infectious Endocarditis caused by bacteria from oral foci |
| Number of Participants with Cardiac implantable electronic device risk of IE | Through study completion, an average of 1 year | Cardiac implantable electronic device risk of IE |
| Number patients with Bacteremia assessed by positive blood culture | Through study completion, an average of 1 year | Cases of bacteremia in the population |
Countries
Denmark
Contacts
Primary ContactLytfi Krasniqi, MD
Outcome results
None listed