Dr. James Gossage, Director at Augusta HHT Center:  Antibiotic prophylaxis is recommend before dental procedures that involve manipulation of the gingival tissues (such as cleaning and extractions) and certain other potentially non-sterile procedures such as surgery on respiratory mucosa.  It is not recommended for typically sterile procedures like heart catheterization, gall bladder surgery and gastrointestinal endoscopy.  Click here for a more detailed list of recommendations.

Some people with HHT have abnormalities in the liver that can actually cause or contribute to heart failure. The possibility of liver AVMs should be considered in a patient with both HHT and high output heart failure, particularly if the heart failure occurs at a relatively young age. Currently, most of the treatments that have been successful in treating the telangiectasia and AVMs elsewhere in the body have proven dangerous when done on the liver. It is particularly important for someone with HHT not to have any treatments involving their liver without contacting an HHT Treatment Center first.

Dr. James Gossage, Director of Augusta HHT Center: There is really no reason why an HHT patient can’t have hip replacement, though the blood thinners are a potential issue. Blood thinners are important to reduce the risk of blood clots during and after the surgery, but are not mandatory. About half of patients with HHT have increased bleeding while on blood thinners, but half don’t.  One option would be a trial of blood thinners before the surgery to see how you do.  If bleeding gets a lot worse, you could work on fixing that problem before the surgery.

Dr. James Gossage, Director of Augusta HHT Center: A colonoscopy is a low risk procedure so no antibiotics are recommended.

Dr. James Gossage, Director of Augusta HHT Center: There are no particular anti-anxiety/antidepressant medications that should be avoided in the typical HHT patient.

Dr. James Gossage, Director of Augusta HHT Center: Overall the benefit of taking a statin outweighs any side effects.  Rarely, it may worsen bleeding but this is uncommon.

Yes, it is safe to get the flu shot with lung AVMs.