What does this research mean for the field?

Surgical explantation with preservation of the native aortic root is a feasible therapeutic strategy for selected patients with TAVI-associated infective endocarditis requiring surgical intervention. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To describe the surgical management and feasibility of explanting an endothelialized balloon-expandable transcatheter aortic valve while preserving the native aortic root in a patient with severe endocarditis.

September 8, 2026CureusOpen Access

Surgical Explantation of a Balloon-Expandable Transcatheter Aortic Valve With Aortic Root Preservation for Prosthetic Valve Endocarditis: A Case Report

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Prosthetic Valve Endocarditis (n=1). Intervention: Surgical explantation with aortic root preservation, biological aortic valve replacement, and ring mitral annuloplasty. Primary outcome: Clinical and echocardiographic improvement.

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Key result

Surgical explantation of an infected TAVR with root preservation and mitral repair successfully resolves severe endocarditis.

Why the study?

Late-onset infective endocarditis following TAVI presents formidable surgical complexity and therapeutic dilemmas due to dense tissue integration of the metallic frame.

Population

One 77-year-old male with late-onset Enterococcus faecalis infective endocarditis after TAVI

Comparison

Complete surgical explantation with aortic root preservation, biological AVR, and ring mitral annuloplasty

Design

Case report

Authors

VDVíctor Manuel Carmona Delgado JGJose Emanuel Pereyda Gamez DCDiego J Oregel CamachoCentro Medico Nacional Siglo XXI

Discussion

Member takes

Implication

Supports root-preserving explantation with mitral repair in select TAVI endocarditis; hypothesis-generating and should not yet change practice.

Key Points

To describe the surgical management and feasibility of explanting an endothelialized balloon-expandable transcatheter aortic valve while preserving the native aortic root in a patient with severe endocarditis.
Evaluated a 77-year-old male with prior transfemoral TAVI and permanent pacemaker presenting with late-onset Enterococcus faecalis endocarditis using multiplanar and 3D transesophageal echocardiography.
Performed urgent open cardiac surgery involving sharp dissection of the integrated metallic stent frame, native aortic root preservation, biological aortic valve replacement, and ring mitral annuloplasty.
Complete explantation of the endothelialized metallic frame was accomplished without requiring aortic root replacement, successfully resolving severe valve obstruction and functional mitral regurgitation.
The postoperative recovery was uneventful, culminating in marked clinical and echocardiographic improvement after completing six weeks of targeted intravenous antibiotic therapy.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

A 77-year-old male with a history of transfemoral TAVI who developed late-onset Enterococcus faecalis infective endocarditis and underwent surgical explantation.

Intervention

Urgent open cardiac surgery consisting of complete explantation of the transcatheter prosthesis, biological aortic valve replacement with aortic root preservation, and ring mitral annuloplasty, followed by 6 weeks of targeted intravenous antimicrobial therapy (ampicillin and ceftriaxone).

Outcome

Clinical and echocardiographic improvement (survival, infection clearance, and valvular hemodynamics) at 12-month follow-up.

Surgical explantation of an infected TAVI prosthesis with native aortic root preservation and concomitant mitral valve repair is a feasible and effective strategy for complicated TAVI-associated infective endocarditis.

Limitations

Single case report with limited generalizability
Limited published experience regarding the surgical management of TAVI-associated infective endocarditis in the region

Cite This Study

Delgado et al. (2026) conducted a case report in Prosthetic Valve Endocarditis (n=1). Surgical explantation with aortic root preservation, biological aortic valve replacement, and ring mitral annuloplasty was evaluated on Clinical and echocardiographic improvement. Surgical explantation of an infected transcatheter aortic valve with aortic root preservation and concomitant mitral valve repair successfully resolved severe prosthetic valve endocarditis.

synapsesocial.com/papers/6a9fd74958e84d0ff5b45cd2 https://doi.org/10.7759/cureus.115851

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September 8, 2026CureusOpen Access

Surgical Explantation of a Balloon-Expandable Transcatheter Aortic Valve With Aortic Root Preservation for Prosthetic Valve Endocarditis: A Case Report

View Full Paper

Ask AI

Bookmark

Key result

Surgical explantation of an infected TAVR with root preservation and mitral repair successfully resolves severe endocarditis.

Why the study?

Late-onset infective endocarditis following TAVI presents formidable surgical complexity and therapeutic dilemmas due to dense tissue integration of the metallic frame.

Population

One 77-year-old male with late-onset Enterococcus faecalis infective endocarditis after TAVI

Comparison

Complete surgical explantation with aortic root preservation, biological AVR, and ring mitral annuloplasty

Design

Case report

Authors

VDVíctor Manuel Carmona Delgado JGJose Emanuel Pereyda Gamez DCDiego J Oregel CamachoCentro Medico Nacional Siglo XXI

Discussion

Member takes

Implication

Supports root-preserving explantation with mitral repair in select TAVI endocarditis; hypothesis-generating and should not yet change practice.

Key Points

To describe the surgical management and feasibility of explanting an endothelialized balloon-expandable transcatheter aortic valve while preserving the native aortic root in a patient with severe endocarditis.
Evaluated a 77-year-old male with prior transfemoral TAVI and permanent pacemaker presenting with late-onset Enterococcus faecalis endocarditis using multiplanar and 3D transesophageal echocardiography.
Performed urgent open cardiac surgery involving sharp dissection of the integrated metallic stent frame, native aortic root preservation, biological aortic valve replacement, and ring mitral annuloplasty.
Complete explantation of the endothelialized metallic frame was accomplished without requiring aortic root replacement, successfully resolving severe valve obstruction and functional mitral regurgitation.
The postoperative recovery was uneventful, culminating in marked clinical and echocardiographic improvement after completing six weeks of targeted intravenous antibiotic therapy.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

A 77-year-old male with a history of transfemoral TAVI who developed late-onset Enterococcus faecalis infective endocarditis and underwent surgical explantation.

Intervention

Outcome

Clinical and echocardiographic improvement (survival, infection clearance, and valvular hemodynamics) at 12-month follow-up.

Limitations

Single case report with limited generalizability
Limited published experience regarding the surgical management of TAVI-associated infective endocarditis in the region

Cite This Study

synapsesocial.com/papers/6a9fd74958e84d0ff5b45cd2 https://doi.org/10.7759/cureus.115851

Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

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