We spent an amazing two days at the historical Bernstorff Castle in Copenhagen, comparing and sharing our 2018 results in pediatric heart surgery. This year, as a specific topic, we had the pulmonary valve endocarditis to discuss. We pondered how to prevent and treat these devastating heart valve infections. From our combined results, we could see that the choice for a valve seems to have an effect on the probability of infection. While percutaneous (through the skin) techniques have clear advantages over surgery, causing less morbidity immediately after the procedure, it seems that the percutaneous valves present a higher risk for endocarditis. The lowest risks occur when homograft valves are used.

How does one prevent infections in the heart valves then? Patients have to avoid any lesions in the skin or mucous membranes where bacteria could enter  their system. This sounds simple, but might in actuality prove quite difficult. Many studies show that even tooth brushing causes bacteria escape into the bloodstream. Different studies have different results and the detected bacteremia (presence of bacteria in blood) varies between 0- 53% of cases. Differences in the results mirror the difference among the gum health of the patients.

Few people have a healthy mouth. If you have a significant periodontal inflammation, you can have an inflamed area that is as large as the size of your palm. Most of us fall somewhere in between, but to be honest, many of us should have a healthy mouth. However, several studies show that pediatric heart surgery patients have significantly reduced oral health when compared to other children. This, of course, is a multifactorial problem, but at any rate, we must improve this.

This discussion again reminded us about the importance of oral issues in taking care of one’s overall health. At Koite Health, we believe that we can provide help for our little patients in the future. We are working on it.