The impact of 2007 @entity884 prophylaxis guidelines on the practice of XXXX specialists.

@entity1 @entity1757 @entity299 @entity4794 @entity884
BACKGROUND: the impact of the 2007 American Heart Association @entity884 prophylaxis guidelines on clinician practice has not been well established. Our objective was to evaluate how the American Heart Association @entity884 guidelines changed the practice of cardiologists who manage @entity299 and to ascertain the degree of practice variation among cardiologists. METHODS: a cross-sectional Web-based survey was e-mailed to Canadian (n = 134), Australian (n = 33), New Zealand (n = 9), and a random sample of American (n = 250) pediatric and adult @entity299 cardiologists in 2008. Nonrespondents received the survey 4 times by e-mail and once by regular post. RESULTS: the response rate was 55%. The lesions for which cardiologists were most evenly divided between recommending versus not recommending prophylaxis were " @entity4794 of moderate severity" (45% recommended prophylaxis) and "perimembranous @entity1757 ( @entity1757 ) status post surgical patch closure with no residual shunt 3 months post-operatively" (54% recommended prophylaxis). The lesions for which the greatest proportion of cardiologists discontinued prophylaxis were "small muscular @entity1757 , no previous @entity884 " (80% discontinued prophylaxis) and "small audible patent ductus arteriosus" (83% discontinued prophylaxis). Only 69% recommended prophylaxis for " @entity1757 s/p surgical patch closure with small residual shunt" despite current guidelines recommending prophylaxis for this scenario. Twenty-eight percent of respondents felt that the new guidelines leave some @entity1 at risk, and 6% would not recounsel any low-risk @entity1 following these guidelines. CONCLUSIONS: the 2007 guidelines have resulted in a substantial change in @entity884 prophylaxis. There remains considerable heterogeneity among cardiologists regarding the prophylaxis of certain @entity299 .
