Case Report (n=1)
No
This case highlights that patients with prosthetic valve endocarditis after TAVR may develop pseudoaneurysms of the ascending aorta, which can be successfully treated with surgical explantation and aortic replacement.
May warrant vigilance for aortic pseudoaneurysms in post-TAVR endocarditis; leaves open optimal management strategies.
An 82-year-old man who underwent transcatheter aortic valve replacement (TAVR) using a 34-mm Evolut PRO (Medtronic, Minneapolis, MN, USA) for severe aortic stenosis 21 months previously presented with fever. Transesophageal echocardiography showed thickening of the valve leaflets of the transcatheter heart valve and movable structures such as verrucae on the upper edge of the Evolut PRO stent. Contrast-enhanced cardiac computed tomography showed a 72-mm saccular pseudoaneurysm on the dorsal aspect of the ascending aorta at the superior border of the Evolut PRO stent. Because of a suspected infected aortic aneurysm caused by prosthetic valve endocarditis (PVE), we performed aortic valve replacement using 23 mm Avalus (Medtronic, Minneapolis, MN, USA) and ascending aortic replacement using 26 mm Gelweave (Vascutek Terumo Inc, Scotland, UK). The postoperative course was uneventful. This report highlights that patients with PVE after TAVR may develop pseudoaneurysms of the ascending aorta.
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Tomita et al. (2022) conducted a case report in Prosthetic valve endocarditis with giant pseudoaneurysm of the ascending aorta after TAVR (n=1). Surgical aortic valve replacement and ascending aortic replacement was evaluated on Clinical outcome (survival and recurrence).
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