Key result
Conservative IV antibiotics successfully resolve post-TAVI infective endocarditis complicated by septic embolic stroke.
Why the study?
Infective endocarditis following transcatheter aortic valve implantation is an uncommon complication with high morbidity and mortality, including ischemic stroke from septic emboli.
Case Report (n=1)
No
This case demonstrates that conservative management with antibiotics can be a successful strategy for post-TAVI infective endocarditis complicated by septic embolic stroke in patients with high surgical risk.
May support conservative management in select high-risk post-TAVI endocarditis; hypothesis-generating and requires prospective validation.
Transcatheter aortic valve implantation (TAVI) is a relatively novel procedure developed for aortic stenosis (AS) management in patients with moderate to high surgical risk, especially the elderly with multiple comorbidities. Infective endocarditis following transcatheter aortic valve implantation (post-TAVI-IE) is an uncommon complication that contributes to very high morbidity and mortality. Further complications from post-TAVI-IE include ischemic stroke from septic emboli. Here, we report a case of an 82-year-old man with severe symptomatic AS who underwent TAVI, presenting with fever and alteration of consciousness, which was diagnosed as post-TAVI-IE per Duke criteria complicated by acute hemiparesis from septic emboli stroke. He was treated successfully conservatively using antibiotics. We have reviewed the options of treatment and outcomes for post-TAVI-IE.
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Arayakarnkul et al. (2022) conducted a case report in Infective endocarditis after transcatheter aortic valve implantation (post-TAVI-IE) with septic embolic stroke (n=1). Conservative management with intravenous antibiotics was evaluated on Clinical recovery and survival. Conservative management with intravenous antibiotics successfully treated an 82-year-old man who developed infective endocarditis and a septic embolic stroke following transcatheter aortic valve implantation.
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