Prosthetic aortic valve endocarditis after transcatheter aortic valve implantation

Prosthetic Valve Endocarditis After Transcatheter Valve Replacement

“…11,12) wereobtained in about one-half of the patients with previous TVR (53.1% of TAVR patients and 47.1% of TPVR patients). Less common causal agents included Gramnegative bacilli in 3 cases, Corynebacterium (2 cases), fungal infections (Candida albicans and Aspergillus fumigatus), Histoplasma capsulatum, Bartonella henselae, and Granulicatella adjacens (1 case each).…”

Prosthetic Valve Endocarditis with Valvular Obstruction after Transcatheter Aortic Valve Replacement

“…12 Of 12 patients [13][14][15][16][17][18][19][20] who were given medical therapy, 5 died. [17][18][19][20] Enterococcus faecalis was the infective organism in 7 of the patients, [10][11][12]16,17,20 S. viridans in 3, 3,5,20 coagulasenegative staphylococci in 2, 14,19 and Corynebacterium, 4 E. durans, 8 Pseudomonas, 9 Moraxella, 15 Candida, 18 methicillin-resistant Staphylococcus aureus, 20 and Escherichia coli in one patient each. 20 No organism was identified in 2 patients, 6,7 although Histoplasma was cultured from the explanted valve in one.…”

“…Optimal medical management is sometimes not enough, and surgical aortic valve replacement might be necessary in high-risk patients who earlier were not considered to be surgical candidates. Prosthetic valve endocarditis appears to have a low prevalence after TAVR: our review of the medical literature yielded 17 cases of TAVR endocarditis [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] and a single-center cohort that summarized 5 other post-TAVR cases of PVE. 20 All 22 patients had varying presentations, pathogens, and treatment; however, none reportedly had endocarditis that caused obstruction or significant gradient changes across the aortic valve on echocardiograms.…”

“…6 One patient 13 had multibacterial flora in the culture. Edwards Sapien prostheses were used in 16 of the patients 3,[5][6][7][8][9][10][11][12][13]17,18,20 and CoreValve ® prostheses (Medtronic, Inc.; Minneapolis, Minn) in 6. 4,[14][15][16]19,20 The interval between TAVR and hospitalization for PVE ranged from less than 2 weeks 13,18 to 23 months.…”