Cargando…

Transcatheter aortic valve replacement for acute aortic regurgitation due to Staphylococcus aureus infective endocarditis complicated with a perivalvular abscess: a case report

BACKGROUND: Infective endocarditis is a life-threatening disease associated with high mortality. Appropriate antimicrobial treatment and cardiac surgery, when indicated, are closely related to prognosis. When cardiac surgery is contraindicated, prognosis worsens dramatically. There is few data conce...

Descripción completa

Detalles Bibliográficos
Autores principales: Vila-Olives, Rosa, Oristrell, Gerard, Rello, Pau, Fernández-Hidalgo, Núria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10117374/
https://www.ncbi.nlm.nih.gov/pubmed/37090761
http://dx.doi.org/10.1093/ehjcr/ytad166
_version_ 1785028598785114112
author Vila-Olives, Rosa
Oristrell, Gerard
Rello, Pau
Fernández-Hidalgo, Núria
author_facet Vila-Olives, Rosa
Oristrell, Gerard
Rello, Pau
Fernández-Hidalgo, Núria
author_sort Vila-Olives, Rosa
collection PubMed
description BACKGROUND: Infective endocarditis is a life-threatening disease associated with high mortality. Appropriate antimicrobial treatment and cardiac surgery, when indicated, are closely related to prognosis. When cardiac surgery is contraindicated, prognosis worsens dramatically. There is few data concerning the use of transcatheter aortic valve replacement after healed aortic valve endocarditis or during active IE. We present the first case report of a transcatheter aortic valve replacement implanted during antimicrobial therapy for a severely symptomatic acute aortic regurgitation due to an infective endocarditis complicated with a perivalvular abscess. CASE SUMMARY: A 68-year-old man was admitted due to left hemiparesis and fever. An acute ischaemic stroke with haemorrhagic transformation was diagnosed. Blood cultures were positive for methicillin-susceptible Staphylococcus aureus and a transoesophageal echocardiogram revealed an aortic endocarditis with an acute severe aortic regurgitation and a perivalvular abscess. Urgent cardiac surgery was contraindicated due to intracranial haemorrhage. However, the patient developed refractory pulmonary oedema and haemodynamic instability. Despite the perivalvular abscess, a transcatheter aortic valve replacement was successfully performed 15 days after the diagnosis. Nine months after completing antimicrobial therapy, there were no signs of relapse. DISCUSSION: Transcatheter aortic valve replacement could be considered in selected patients with symptomatic severe aortic regurgitation due to aortic infective endocarditis during antimicrobial therapy when cardiac surgery is contraindicated.
format Online
Article
Text
id pubmed-10117374
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-101173742023-04-21 Transcatheter aortic valve replacement for acute aortic regurgitation due to Staphylococcus aureus infective endocarditis complicated with a perivalvular abscess: a case report Vila-Olives, Rosa Oristrell, Gerard Rello, Pau Fernández-Hidalgo, Núria Eur Heart J Case Rep Case Report BACKGROUND: Infective endocarditis is a life-threatening disease associated with high mortality. Appropriate antimicrobial treatment and cardiac surgery, when indicated, are closely related to prognosis. When cardiac surgery is contraindicated, prognosis worsens dramatically. There is few data concerning the use of transcatheter aortic valve replacement after healed aortic valve endocarditis or during active IE. We present the first case report of a transcatheter aortic valve replacement implanted during antimicrobial therapy for a severely symptomatic acute aortic regurgitation due to an infective endocarditis complicated with a perivalvular abscess. CASE SUMMARY: A 68-year-old man was admitted due to left hemiparesis and fever. An acute ischaemic stroke with haemorrhagic transformation was diagnosed. Blood cultures were positive for methicillin-susceptible Staphylococcus aureus and a transoesophageal echocardiogram revealed an aortic endocarditis with an acute severe aortic regurgitation and a perivalvular abscess. Urgent cardiac surgery was contraindicated due to intracranial haemorrhage. However, the patient developed refractory pulmonary oedema and haemodynamic instability. Despite the perivalvular abscess, a transcatheter aortic valve replacement was successfully performed 15 days after the diagnosis. Nine months after completing antimicrobial therapy, there were no signs of relapse. DISCUSSION: Transcatheter aortic valve replacement could be considered in selected patients with symptomatic severe aortic regurgitation due to aortic infective endocarditis during antimicrobial therapy when cardiac surgery is contraindicated. Oxford University Press 2023-04-12 /pmc/articles/PMC10117374/ /pubmed/37090761 http://dx.doi.org/10.1093/ehjcr/ytad166 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Vila-Olives, Rosa
Oristrell, Gerard
Rello, Pau
Fernández-Hidalgo, Núria
Transcatheter aortic valve replacement for acute aortic regurgitation due to Staphylococcus aureus infective endocarditis complicated with a perivalvular abscess: a case report
title Transcatheter aortic valve replacement for acute aortic regurgitation due to Staphylococcus aureus infective endocarditis complicated with a perivalvular abscess: a case report
title_full Transcatheter aortic valve replacement for acute aortic regurgitation due to Staphylococcus aureus infective endocarditis complicated with a perivalvular abscess: a case report
title_fullStr Transcatheter aortic valve replacement for acute aortic regurgitation due to Staphylococcus aureus infective endocarditis complicated with a perivalvular abscess: a case report
title_full_unstemmed Transcatheter aortic valve replacement for acute aortic regurgitation due to Staphylococcus aureus infective endocarditis complicated with a perivalvular abscess: a case report
title_short Transcatheter aortic valve replacement for acute aortic regurgitation due to Staphylococcus aureus infective endocarditis complicated with a perivalvular abscess: a case report
title_sort transcatheter aortic valve replacement for acute aortic regurgitation due to staphylococcus aureus infective endocarditis complicated with a perivalvular abscess: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10117374/
https://www.ncbi.nlm.nih.gov/pubmed/37090761
http://dx.doi.org/10.1093/ehjcr/ytad166
work_keys_str_mv AT vilaolivesrosa transcatheteraorticvalvereplacementforacuteaorticregurgitationduetostaphylococcusaureusinfectiveendocarditiscomplicatedwithaperivalvularabscessacasereport
AT oristrellgerard transcatheteraorticvalvereplacementforacuteaorticregurgitationduetostaphylococcusaureusinfectiveendocarditiscomplicatedwithaperivalvularabscessacasereport
AT rellopau transcatheteraorticvalvereplacementforacuteaorticregurgitationduetostaphylococcusaureusinfectiveendocarditiscomplicatedwithaperivalvularabscessacasereport
AT fernandezhidalgonuria transcatheteraorticvalvereplacementforacuteaorticregurgitationduetostaphylococcusaureusinfectiveendocarditiscomplicatedwithaperivalvularabscessacasereport