Prosthetic valve endocarditis: Literally a growing concern following transcatheter aortic valve replacement

Abstract

Key Points Prosthetic valve endocarditis (PVE) following transcatheter aortic valve replacement (TAVR) in low surgical risk patients is uncommon, occurring in 11 of 396 patients (2.8%) in the study by Medranda et al., but associated with high morbidity (6 of 11 with embolic strokes [55%]) and mortality (2 of 11 [18%]). As TAVR volumes increase, especially in low surgical risk patients, whose long‐term outcomes are generally excellent, PVE will become an increasingly important concern. Future research is needed to identify optimal strategies for prevention, diagnosis, and treatment of PVE associated with TAVR.

Diagnostic Evaluation of Stroke Etiology

“…Although transcatheter aortic valve replacement generally has lower overall risk than open surgical aortic valve replacement, the risk of subsequent endocarditis appears to be comparable with both valve procedures. 41 In an administrative data review of nonfederal acute care hospitals in California, the absolute increase in risk of stroke was 9.1% in the month after diagnosis of infectious endocarditis. 42 Interestingly, the risk of stroke was significantly elevated in the 4 months preceding the diagnosis of infectious endocarditis.…”