Secondary prevention
Vaccination against respiratory syncytial virus is indicated during the appropriate season.
Infective endocarditis prophylaxis before dental procedures or for procedures on the respiratory tract or infected skin, skin structures, or musculoskeletal tissue is required for unrepaired cyanotic congenital heart disease (CHD), including palliative shunts and repaired CHD with residual defects at or adjacent to the site of a prosthetic patch or device.[35]
Educating patients with Tetralogy of Fallot (TOF) about the significance of maintaining oral health is crucial to prevent bacteremia and subsequent infective endocarditis.[36]
Patients with TOF should have preconception counseling. Women with repaired TOF should be evaluated by high-risk obstetrics and a congenital cardiologist before pregnancy. The risk of having an offspring with CHD increases 10-fold with an affected first-degree relative.[56]
A screening fetal echocardiogram may be indicated in a pregnant mother who has had other children with CHD or has CHD herself. There are no clear guidelines.
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