Prosthetic valve endocarditis after transcatheter aortic valve implantation-diagnostic and surgical considerations

Transcatheter aortic valve implantation (TAVI) has emerged as an excellent alternative therapeutic option to surgical aortic valve replacement (SAVR) in high-risk or inoperable patients who are suffering from severe symptomatic aortic valve disease (1). Prosthetic valve endocarditis (PVE) is a life threatening condition. A few cases having successful SAVR after TAVI were reported. TAVI-PVE has in general been treated conservatively due to the inherent high operative risk (2). Thus, there is no established consensus on the management of this patient category (3). The prevalence of endocarditis in patients with a prosthetic valve has ranged from 1% to 6% with an incidence of 0.3% to 1.2% within the first year after intervention (4,5). The causative microorganisms typically are staphylococci, streptococci and enterococci (4)