Surgery for fulminant prosthetic valve endocarditis after transapical transcatheter aortic valve-in-valve implantation.
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.
Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany.
Manuel
M
Wilbring
Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany.
Sems Malte
SM
Tugtekin
Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany.
Klaus
K
Matschke
Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany.
Utz
U
Kappert
D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation*; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D017809:Fatal Outcome; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome