The current view of doctors is that patients who have to undergo oral treatment (as small as scaling) after valve replacement should be treated not only with antibiotics, but also with needle antibiotics. Endocarditis, an infection of the heart valves or muscles, is the number one cause of central failure in people aged 15 to 35 years. Infective endocarditis can have many different clinical manifestations. The cause is a variety of clinical manifestations as small emboli break off from a large bulky mass and cause embolism in other parts of the body. If the embolus reaches the brain, it can cause weakness or blindness in one limb, often mistaken for a stroke; if it reaches the lung, it may have pneumonia-like manifestations; if it reaches the liver, it may develop a liver abscess; if it reaches the fingertip, it may develop a painful lump or bleeding under the nail. Although it is tedious to inject antibiotics for even a minor oral treatment, it is worth it compared to the consequences of infection if it occurs. The following antibiotics are recommended: Patients who are not allergic to penicillin 1. In adults, ampicillin 1.0-2.0 g gentamicin plus 1.5 mg/kg intramuscularly or intravenously 30 minutes prior to oral treatment and 6 hours after oral treatment. 2. Patients who are allergic to penicillin. Adults are given vancomycin 1 g intravenously 60 minutes prior to oral treatment, with dosing lasting longer than 60 minutes. Repeat dose is not required. 3.Children should be given vancomycin 20 mg/kg intravenously for more than 60 minutes prior to oral treatment. Repeat dosing is not required. 4.Vancomycin may occasionally cause flushing of the upper body as a side effect, called “red neck reaction”, which mostly disappears within 15-20 minutes, and can be prevented by taking benadryl 30 minutes before dosing. 5.Patients of Marfan without flap replacement should take oral penicillin or ampicillin before and after each oral treatment.