Are All Ventricular Septal Defects Created Equal?

Daniela Lax, Rajan D. Bhatt, Scott E. Klewer, Vincent L. Sorrell

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


The authors report the occurrence of infective endocarditis in a 32-year-old man with a ventricular septal defect and a left ventricular-to-right-atrial shunt who adhered to the revised 2007 American Heart Association guidelines for infective endocarditis. The patient had received antibiotic prophylaxis prior to multiple previous dental procedures. At a recent dental evaluation for fillings, he was informed that he no longer needed prophylaxis. Fatigue and fevers developed 1 week later, and he was treated with an oral course of ciprofloxacin. The symptoms recurred, and blood cultures grew Streptococcus viridans. A 7-mm vegetative mass was seen on the septal leaflet of the tricuspid valve during transesophageal echocardiography. This report raises the concern that patients with ventricular septal defects and left ventricular-to-right-atrial shunts are at higher risk for endocarditis and may require antibiotic prophylaxis.

Original languageEnglish (US)
Pages (from-to)791.e5-791.e7
JournalJournal of the American Society of Echocardiography
Issue number7
StatePublished - Jul 2010


  • Endocarditis
  • Gerbode defect
  • Left ventricular-to-right atrial shunt
  • Ventricular septal defect

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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