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Bacterial endocarditis prophylaxis is not indicated in the management of our patient. Recommendations for its use were discontinued in 2007 by the American Heart Association, because no evidence exists attesting to its efficacy. However, use of bacterial endocarditis prophylaxis is indicated in some patients at high risk for whom a possible benefit can be justified. Such high risk patients include those with unoperated cyanotic defects, a prior history of infective endocarditis, prosthetic valves and in the first six months after repair of defects with prosthetic material.