Tooth extraction before CABG? why?

SandraCVRN · Mar 2, 2011

I've seen this with valves and only on those with really bad dentition not as a routine pre-op.

I care there4 I amRN · Mar 3, 2011

thx for ur response, i think that was the case, the pts i have seen have the procedure all had some dental issues.

nursej22, MSN, RN · Mar 3, 2011

Streptococcus viridans, an normal oral flora, has a high affinity for endocardium and heart valves. When it enters the bloodstream as a result dental work or periodontal disease it can attack the heart valves resulting in vegetation and erosion as well as septic emboli.

Poor dental hygiene is often the culprit in endocarditis so the bad teeth are often removed prior to valve replacement, otherwise the new valve gets infected too.

And that seldom has a good outcome.

I care there4 I amRN · Mar 4, 2011

ur response was very detailed and really clarified some things for me :) :tku:

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I care there4 I amRN · Mar 21, 2011

thanks I will watch the videos :):tku:

KD CVICU-RN · Mar 24, 2011

The bacteria that are produced from either periodontal disease, or as I am assuming in this case, the death of the pulp of the tooth can get into the circulation blood. That all just means that the patient would need to have a root canal, or if it was beyond saving, an extraction. When a tooth dies, it becomes interally necrotic and releases these gram-neg. bacteria which circlate throuout the bloodstream, eventually causing growths of bacterial vegetation within the heart.