Is prophylaxis against infective endocarditis recommended in atrial septal defect ? Prophylaxis against infective endocarditis is not recommended for patients with atrial septal defects (repaired or unrepaired) unless a concomitant valvular abnor-mality (e.g. mitral valve cleft or prolapse) is present. Leonardo da Vinci's description in 1513 of a 'perforating channel' in the atrial septum is believed to be the first recorded account of a congenital malformation of the human heart. Rene Lutembacher, a French physician, described the Lutembacher syndrome in 1916. Mary Holt, cardiologist, King% Culluge Hu~pltdI, London. Samuel Oram, cardiologist, King's College Hospital, London.
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