dimps
Forum Guru
Topics: 63
Posts: 446
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A 36-year-old man comes to your office for preoperative evaluation prior to his elective rotator cuff
repair. He tore his rotator cuff playing baseball and an orthopedic surgeon feels that the repair can be
made arthroscopically. The patient had already met with his anesthesiologist and was given a minimal
risk for any major complications. The patient reports that he has mitral valve prolapse and that the
anesthesiologist was curious as to whether the patient has ever had an echocardiogram. The patient
specifically is requesting this test today. He is otherwise healthy, with a negative review of systems and
no regular medications. He has no heart murmur present on physical examination. His procedure is
tomorrow. The most appropriate management at this time is to
A. advise the patient that no antibiotic prophylaxis is necessary
B. obtain an echocardiogram and delay the surgery until results are available
C. order blood cultures preoperatively
D. recommend antibiotic prophylaxis to cover for infective endocarditis
E. refuse to obtain the echocardiogram
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hi how r u
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| doods
Forum Newbie
Topics: 0
Posts: 33
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i think answer is A. no need for prophylaxis. only certain surgeries that carry risk of bacteremia are given prophylaxis (like GI and GU surgeries, and dental procedures). And only mitral valve prolapse with mitral regurgitation is given prophylaxis. If this were another surgical procedure, I would answer B to be sure that patient doesnt have MR, but since it is only a rotator cuff repair, I would answer A.
Im not sure ok?? Just giving my opinion 
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| vango
Forum Newbie
Topics: 0
Posts: 5
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I would agree with the prior person "A" is my choice as well.
"And only mitral valve prolapse with mitral regurgitation is given prophylaxis"
But I think I would still pick A if it were any other surg, because there is no indication of a murmur, if the pat did have signs or MR then i would agree with abx prophy
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