Infective endocarditis following transcatheter aortic valve implantation |
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Institution: | 1. Rigshospitalet University Hospital, Copenhagen, Denmark;2. King Chulalongkorn Memorial Hospital, Bangkok, Thailand;1. University of Toronto, Departments of Laboratory Medicine & Pathobiology & Departments of Pathology & Cardiovascular Surgery, Toronto General Hospital, University Health Network, Toronto, Canada;3. Division of Cardiovascular Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada |
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Abstract: | Trans-catheter aortic valve implantation (TAVI) has recently emerged as a less invasive alternative to surgical aortic valve replacement (SAVR) in high risk patients. Although several procedures have been performed worldwide, infective endocarditis (IE) has been reported to be a rare TAVI complication, nevertheless if IE occurs it represents a life-threatening condition and treatment is challenging. TAVI-IE are thus normally treated conservatively by targeted antibiotic therapy with a high reported mortality (40%). Surgical explant represent the definitive strategy but, the intervention is at a high risk (risk of complication 87%, with an in hospital mortality of about 47%). In the present paper, we report the case of a 71-year-old patient affected by an early endocarditis after TAVI (TAVI-IE) treated at our Institution by surgical explant. The case highlights a paradox: if TAVI procedures are indicated over traditional surgical valve replacement in treatment of high surgical risk patients, what should be the best management when TAVI-IE occurs in these same population of patients? |
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Keywords: | Trans-catheter aortic valve implantation Infective endocarditis Implantation transcathéter de valve aortique Endocardite infectieuse |
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