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Introduction: Transcatheter aortic valve infective endocarditis is a life-threatening complication. Transcatheter aortic valve infective endocarditis (TAVIE) mortality caused by Candida parapsilosis is unknown. Clinical Case:We present a case of a 73-year-old female diagnosed with severe aortic stenosis secondary to bicuspid aortic valve and coronary artery disease with a significant lesion of the proximal left anterior descending artery, treated with one sirolimus-eluting stent and transcatheter aortic valve replacement. A month later she began with persistent fever and hypotension. A transesophageal echocardiogram (TEE) showed vegetations adhered to the transcatheter aortic valve prosthesis with a moderate posterior paravalvular leak. Positive blood cultures were obtained with Candida parapsilosis isolation. She was treated with Amphotericin B plus voriconazole and underwent surgical aortic valve replacement. Unfortunately, surgery was complicated with aortic and coronary arteries dissection, cardiorespiratory arrest and death.The transesophageal echocardiography had an excellent correlation with surgical findings.

What is the differential diagnosis of the finding noted in the descending aorta in a patient with hemoptysis? A patient in their 40s with a 6-month history of intermittent hemoptysis and anemia presented to the emergency department with newonset dyspnea and massive hemoptysis. The patient had a remote history of cocaine use and recent negative test results for HIV and tuberculosis. On admission, an electrocardiogram showed sinus tachycardia. The patient's hemoglobin level was 8 g/dL (to convert to grams per liter, multiply by 10). A transthoracic echocardiogram was performed. An unusual echodensity was noted in the descending aorta; an ultrasonic-enhancing agent was given for better visualization (Figure , A; Video). A contrast chest computed tomography scan was then performed. An aortic pseudoaneurysm with an aortobronchial fistula was evident (Figure, B and C). A Medtronic Valiant Captiva stent graft 157 mm × 32/32 mm in size was placed satisfactorily. The patient was discharged without complications and continues to receive follow-up care in the outpatient clinic. 1,2