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With the back against the wall: TAVI in a patient with endocarditis
Author(s) -
Albu Ciprian,
Swaans Martin J.,
Berg Jurien M.
Publication year - 2013
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.24772
Subject(s) - medicine , endocarditis , asymptomatic , aortic valve replacement , aortic valve , stenosis , cardiology , surgery , infective endocarditis , sepsis , aortic valve stenosis , valve replacement
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. © 2012 Wiley Periodicals, Inc.