Prosthetic valve endocarditis after transcatheter aortic valve implantation complicated by paravalvular abscess and treated by pericardial patches and sutureless valve replacement

Abstract

Background: Endocarditis is a rare complication of transcatheter aortic valve implantation (TAVI), with an estimated 1-year incidence of 0.50% [Circulation 2015]. However, ensuing consequences are often dire, and its surgical treatment poses unique problems, due to the frequent underlying frailty of TAVI recipients. Case Report: We report the case of an 84-year-old woman, who developed Staphylococcus aureus prosthetic valve endocarditis (PVE) 7 days after transfemoral TAVI (ACURATE neo™, Boston Scientific or Symetis, further complicated by an aortic annular abscess with fistulization into the right atrium. The patient underwent successful operative aortic annulus repair, using pericardial patches, and aortic valve replacement with a sutureless Perceval S bioprosthesis (LivaNova). Conclusion: Our case documents the treatment of an active fistulizing Symetis ACURATE neo ™ prosthetic aortic valve endocarditis by using a sutureless LivaNova Perceval S prosthesis with satisfying hemodynamic results and an encouraging 1-year outcome, further corroborating its usefulness in such circumstances.