Key result
Surgical AVR successfully treats post-TAVI Pseudomonas aeruginosa endocarditis in a high-risk patient.
Why the study?
Prosthetic valve endocarditis is a rare but serious complication after TAVI with no specific treatment guidelines and challenging diagnosis.
Case Report (n=1)
No
Open surgical aortic valve replacement may be a viable and necessary treatment for TAVI-associated prosthetic valve endocarditis despite high surgical risk.
Answers are grounded in this paper and cite their sources.
May support surgical aortic valve replacement for rare Pseudomonas endocarditis post-TAVI in high-risk patients; leaves open optimal management strategies.
Transcatheter aortic valve implantation (TAVI) is an alternative treatment for severe aortic valve stenosis (AS) in patients with prohibitive risk for surgical aortic valve replacement (SAVR). Prosthetic valve endocarditis (PVE) is a rare complication of this relatively novel procedure and current guidelines do not include specific recommendations for its treatment. We report a case of PVE due to Pseudomonas aeruginosa after TAVI that required SAVR, with successful outcome. PVE usually occurs during the first year after TAVI and entails a high mortality risk because patients eligible for this min-imally invasive procedure are fragile (i.e. advanced age and/or severe comorbidities). Additionally, clinical presentation may be atypical or subtle and transesophageal echocardiogram (TEE) may not be conclusive, which delays diagnosis and treatment worsening the prognosis. This case highlights that open SAVR might be ultimately indicated as part of treatment for TAVI-PVE despite a high-risk surgery score.
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Dapás et al. (2016) conducted a case report in Prosthetic valve endocarditis following TAVI (n=1). Surgical Aortic Valve Replacement (SAVR) was evaluated on Survival and infection relapse. Open surgical aortic valve replacement successfully treated Pseudomonas aeruginosa prosthetic valve endocarditis following transcatheter aortic valve implantation in a high-risk patient.
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