Abstract
Prosthetic valve endocarditis after transcatheter aortic valve implantation (TAVI) is a rare complication associated with a high mortality rate. Nonetheless, the rapid expansion of TAVI in recent years has proportionally increased the number of patients exposed to the risk of developing transcatheter valve infection. A 71-year-old female with recent history of TAVI was diagnosed with prosthetic valve obstruction secondary to endocarditis. The characteristics of clinical presentation of endocarditis in the balloon-expandable transcatheter valve and the intra-operative findings are discussed with a review of the literature and tips of management.
Highlights
Prosthetic valve endocarditis after transcatheter aortic valve implantation (TAVI) is a rare complication associated with a high mortality rate
Based on the existing surgical indications of distal embolization, large vegetation (> 1 cm), aortic valve obstruction with heart failure, and persistent positive blood cultures despite IV antibiotic therapy [1], once her general conditions had improved with a full neurologic recovery, she was taken to surgery 2 weeks after admission for removal of the transcatheter valve and surgical aortic valve replacement (SAVR)
The Infectious Endocarditis after TAVI International Registry retrospectively collected data from patients diagnosed with infective endocarditis after TAVR from 47 sites across Europe, North America, and South America between 2005 and 2015 [2]
Summary
Prosthetic valve endocarditis after transcatheter aortic valve implantation (TAVI) is a rare complication associated with a high mortality rate. Based on the existing surgical indications of distal embolization, large vegetation (> 1 cm), aortic valve obstruction with heart failure, and persistent positive blood cultures despite IV antibiotic therapy [1], once her general conditions had improved with a full neurologic recovery, she was taken to surgery 2 weeks after admission for removal of the transcatheter valve and surgical aortic valve replacement (SAVR). She underwent SAVR with a 23 mm bio-prosthesis. The trans-catheter valve prosthesis was involved by growth of a bulky vegetation obstructing the orifice
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