Pseudomonas aeruginosa Infective Endocarditis Following Transcatheter Aortic Valve Implantation: A Note of Caution

The Open Cardiovascular Medicine Journal 19 Feb 2016 RESEARCH ARTICLE DOI: 10.2174/1874192401610010028


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.

Keywords: Infective endocarditis, prosthetic valve endocarditis, Pseudomonas aeruginosa, TAVI, TAVI associated endocarditis, transcatheter aortic valve implantation.
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