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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:04

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

Fungal endocarditis after transfemoral aortic valve implantation

Stuart J Head1, Todd M Dewey, Michael J Mack

  • 1Cardiopulmonary Research Science and Technology Institute, Dallas, Texas, USA. s.head@erasmusmc.nl

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|May 7, 2011
PubMed

Insights

Transcatheter aortic valve implantation (TAVI) is an alternative for surgical aortic valve replacement. This case highlights a rare Histoplasma capsulatum infection after TAVI, requiring valve explantation and successful recovery.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Case Reports

Background:

  • Transcatheter aortic valve implantation (TAVI) emerged as a less invasive alternative to surgical aortic valve replacement (SAVR) for aortic stenosis in 2006.
  • Endocarditis post-TAVI is infrequently documented, raising concerns due to potential re-operation necessity in high-risk patients.
  • This case addresses the management of endocarditis in a patient previously deemed inoperable for SAVR.

Observation:

  • A patient, unsuitable for SAVR, underwent TAVI for severe aortic stenosis.
  • Months post-TAVI, the patient presented with recurrent, self-limiting fevers of unknown origin.
  • Diagnostic workup confirmed endocarditis affecting the implanted valve.

Findings:

  • Infective endocarditis was diagnosed in a patient who had previously received TAVI.
  • Surgical explantation of the TAVI valve was performed.
  • Pathological analysis revealed the causative agent to be Histoplasma capsulatum.

Implications:

  • This case underscores the possibility of rare fungal infections, such as Histoplasma capsulatum, following TAVI.
  • It demonstrates the feasibility of surgical valve explantation and successful recovery in high-risk patients who have undergone TAVI.
  • Highlights the importance of considering diverse etiologies for fever of unknown origin after TAVI.

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