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      With the back against the wall: TAVI in a patient with endocarditis.

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          Abstract

          Transcatheter Aortic Valve Implantation (TAVI) is currently a well-established therapeutic option in patients with severe aortic stenosis considered at prohibitive risk for open heart aortic valve replacement (Cribier et al., Circulation 2002;106:3006-3008; Leon et al., Semin Thorac Cardiovasc Surg 2006;18:165-174). We report a case of a patient with endocarditis by severe homograft aortic stenosis for which a TAVI procedure was performed with an excellent result. The patient was undergoing a presurgery standard screening in preparation for a planned aortic valve replacement operation when he developed a Staphyloccocus aureus sepsis. Transoesophageal echocardiography demonstrated an aortic valve vegetation. A few days later, the patient developed a stroke probably due to embolization of a vegetation. Given the clinical severity of the case a standard open heart aortic valve replacement was considered too risky and the patient underwent a TAVI procedure. Postintervention the patient had a spectacular evolution with fast normalization of the septic shock parameters and clinical status. Antibiotics were continued for a total of nine weeks. By the ambulatory controls at three weeks, two months and six months postdischarge, the patient was completely asymptomatic and his echocardiography showed a normally functioning aortic valve without indications of endocarditis.

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          Author and article information

          Journal
          Catheter Cardiovasc Interv
          Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
          Wiley
          1522-726X
          1522-1946
          Oct 01 2013
          : 82
          : 4
          Affiliations
          [1 ] Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, Nieuwegein, the Netherlands.
          Article
          10.1002/ccd.24772
          23225737
          da4bd637-108e-4dfc-8b8d-e852cef6fb93
          History

          TAVI,aortic valve,septic shock,endocarditis
          TAVI, aortic valve, septic shock, endocarditis

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