Surgical Treatment of Patients With Infective Endocarditis After Transcatheter Aortic Valve Implantation

Secondary Ross procedure after failed transcatheter aortic valve replacement

“…Previous studies reported a strikingly high proportion of nonoperative management for post-TAVR endocarditis. 2 It is our speculation that the observed frequent nonoperative management was likely due to poor surgical candidacy rather than intentional medical management.…”

Surgical outcomes and the optimal approach to the treatment of aortic valve endocarditis with an aortic root abscess

“…The widespread diffusion of transcatheter aortic valve implantation (TAVI), unfortunately, did not decrease the magnitude of the problem (yet?). All in all, after aortic valve replacement, either surgical or transcatheter, the reported incidence of IE ranges between 0.7% and 3.4% per patient‐year 4 . And half of that cohort requires surgery due to severe complications: heart failure, uncontrolled infection, prevention of embolism.…”

“…The worldwide increase in TAVI volume is undoubtedly accompanied by an increase in the number of postimplantation endocarditis and eventually periannular complications such as ARA. TAVI IE is associated with a poor prognosis with 33% of the patient experiencing in‐hospital death 4 . Moreover, compared with patients with PVE after surgical valve replacement, both in‐hospital and 1‐year mortality rates are higher in TAVI IE.…”

“…All in all, after aortic valve replacement, either surgical or transcatheter, the reported incidence of IE ranges between 0.7% and 3.4% per patient-year. 4 And half of that cohort requires surgery due to severe complications: heart failure, uncontrolled infection, prevention of embolism.…”

“…TAVI IE is associated with a poor prognosis with 33% of the patient experiencing in-hospital death. 4 Moreover, compared with patients with PVE after surgical valve replacement, both in-hospital and 1-year mortality rates are higher in TAVI IE. TAVI patients affected with postimplant IE are a new challenge and the best treatment is still a matter of discussion, especially in the fragile elderly cohort which still is the main goal of TAVI in many countries, people who could barely survive a standard operation, and very unlikely able to withstand the impact of endocarditis surgery.…”