title: Pseudomonas aeruginosa Infective Endocarditis Following Aortic Valve Implantation: A Note of Caution.
abstract: 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.
authors.affiliation: Department of Infectious Diseases, Hospital Italiano de Mendoza, Argentina.
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Dapás
authors.affiliation: Department of Infectious Diseases, Hospital Italiano de Mendoza, Argentina.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Rivero
authors.affiliation: Department of Cardiovascular Surgery, Hospital Italiano de Mendoza, Argentina.
authors.forename: Pablo
authors.initials: P
authors.lastname: Burgos
authors.affiliation: Department of Infectious Diseases, Hospital Italiano de Mendoza, Argentina.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vila
keywords: Infective endocarditis; Pseudomonas aeruginosa; TAVI; TAVI associated endocarditis; prosthetic valve endocarditis; transcatheter aortic valve implantation