Key result
Antibiotic therapy alone successfully reduced vegetation size and improved complete atrioventricular block to first-degree block in an 80-year-old man with periannular extension of infective endocarditis after transcatheter aortic valve implantation.
Why the study?
There have been no reports of cases with periannular extension of infective endocarditis and atrioventricular block after TAVI successfully treated with antibiotics without valve replacement.
Case Report (n=1)
No
Antibiotic therapy alone may be a viable treatment for periannular extension of infective endocarditis with AV block in high-risk elderly patients post-TAVI.
Answers are grounded in this paper and cite their sources.
May support antibiotic-only management of select post-TAVI periannular IE with AV block; hypothesis-generating and leaves generalizability open.
Background: Although transcatheter aortic valve implantation (TAVI) is performed for very elderly patients in whom surgical aortic valve replacement (SAVR) poses unacceptably high operative risk, some of these patients are ultimately forced to undergo open surgery when TAVI is complicated by infective endocarditis (IE). To our knowledge, there have been no reports of cases with periannular extension of IE and atrioventricular block successfully treated by antibiotics without valve replacement. Case summary: was detected in his blood culture. Electrocardiography (ECG) showed complete atrioventricular block. Transoesophageal echocardiography (TEE) detected vegetation on the anterior mitral leaflet, aorta, and common annulus. Transcatheter aortic valve implantation had been performed rather than SAVR to avoid the associated operative risks. Because his haemodynamic condition was stable, we decided upon antibiotic treatment alone. On Day 42 after admission, TEE showed a reduction in the size of the vegetation, and his ECG recovered to sinus rhythm. Discussion: Medical treatment alone was effective for a periannular extension of IE complicated with complete atrioventricular block in a very elderly patient after TAVI had been performed to avoid high operative risk.
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Hirata et al. (2024) conducted a case report in Infective endocarditis with atrioventricular block after TAVI (n=1). Antibiotic therapy was evaluated on Reduction in vegetation size and recovery of atrioventricular block. Antibiotic therapy alone successfully reduced vegetation size and improved complete atrioventricular block to first-degree block in an 80-year-old man with periannular extension of infective endocarditis after transcatheter aortic valve implantation.
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