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Case Reports
. 2015 Apr 25;12(1):20-22.
doi: 10.1016/j.jccase.2015.03.012. eCollection 2015 Jul.

Successful surgical aortic valve replacement for prosthetic valve infective endocarditis following transcatheter aortic valve implantation

Shinya Takimoto  1 , Kenji Minakata  1 , Kazuhiro Yamazaki  1 , Shingo Hirao  1 , Kentaro Watanabe  1 , Naritatsu Saito  2 , Masao Imai  2 , Shin Watanabe  2 , Hirotoshi Watanabe  2 , Hiroki Daijo  3 , Takeshi Kimura  2 , Ryuzo Sakata  1
Affiliations
Case Reports

Successful surgical aortic valve replacement for prosthetic valve infective endocarditis following transcatheter aortic valve implantation

Shinya Takimoto et al. J Cardiol Cases. .

Abstract

An 80-year-old male underwent a transcatheter aortic valve implantation (TAVI) for severe senile aortic stenosis. Six weeks after the surgery, he was readmitted to our institution because of a high-grade fever. Transesophageal echocardiography revealed thickening of all three leaflets of the aortic prosthesis and mobile mass on the leaflet, and Streptococcus sanguis was identified from his blood culture. Therefore, he was diagnosed with prosthetic valve endocarditis (PVE) and received intensive intravenous antibiotic therapy. Because he did not respond to the pharmacological therapy, surgical aortic valve replacement (AVR) was indicated although it was considered a relatively high-risk procedure. Herein, we report on the successful surgical AVR in this patient using a pericardial valve after removal of the infected prosthetic valve, and discuss some issues related to this rare complication after TAVI. <Learning objective: Transcatheter aortic valve implantation (TAVI) is a highly effective procedure for patients with symptomatic severe aortic stenosis who are at high risk or deemed inoperable. Because it only requires limited surgical invasiveness, the risk of prosthetic valve endocarditis (PVE) after TAVI is thought to be low. However, PVE can occur even early after TAVI. We present our recent such case and discuss some issues related to this rare complication.>.

Keywords: Prosthetic valve endocarditis; Surgical aortic valve replacement; Transcatheter aortic valve implantation.

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Figures

Fig. 1
Fig. 1
Transthoracic echocardiography long-axis view. Masses were identified attached to the prosthetic valve leaflets.
Fig. 2
Fig. 2
Infected prosthesis explanted during the operation. A large-sized mass was seen attached to the aortic surface on one of the leaflets.
See this image and copyright information in PMC

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