Surgery for Fulminant Prosthetic Valve Endocarditis after Transapical Transcatheter Aortic Valve-in-Valve Implantation

Abstract

We report the clinical course of a patient with a history of transapical aortic “valve-in-valve” transcatheter aortic valve implantation (TAVI), actually suffering from prosthetic valve endocarditis. The patient now underwent cardiac surgery as a salvage procedure. The procedure itself was uneventful, but the patient died several days postoperative due to persisting sepsis. The present case raises the question, how to deal with high-risk patients, once considered unsuitable for cardiac surgery in presence of prosthetic valve infection? Up to now, there exists only insufficient knowledge about incidence, clinical course, and effectiveness of treatment strategies for prosthetic valve endocarditis after TAVI. A review of the available literature is given.

Keywords

TAVI - valve-in-valve - endocarditis - prosthetic valve endocarditis

• References

• 1 Tugtekin S, Matschke K, Daubner D , et al. Prosthetic valve endocarditis: importance of surgical treatment. Thorac Cardiovasc Surg 2007; 55 (2) 94-98
• 2 Loh PH, Bundgaard H, Søndergaard L. Infective endocarditis following transcatheter aortic valve replacement: diagnostic and management challenges. Catheter Cardiovasc Interv 2012; (e-pub ahead of print). DOI: 10.1002/ccd.24368.
• 3 Head SJ, Dewey TM, Mack MJ. Fungal endocarditis after transfemoral aortic valve implantation. Catheter Cardiovasc Interv 2011; 78 (7) 1017-1019
• 4 Carnero-Alcázar M, Maroto Castellanos LC, Carnicer JC, Rodríguez Hernández JE. Transapical aortic valve prosthetic endocarditis. Interact Cardiovasc Thorac Surg 2010; 11 (3) 252-253