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Updated: Oct 20, 2025

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

Published on: August 8, 2025

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Prosthetic valve endocarditis after transcatheter aortic valve replacement in low-risk patients

Giorgio A Medranda1, Toby Rogers1,2, Syed W Ali1

  • 1Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|September 10, 2021
PubMed
Abstract

Insights

Prosthetic valve endocarditis (PVE) after transcatheter aortic valve replacement (TAVR) is rare in low-risk patients but leads to significant complications, including stroke and death. Further research is needed to minimize PVE incidence and improve patient outcomes following TAVR.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Prosthetic Valve Endocarditis Research

Background:

  • Prosthetic valve endocarditis (PVE) is a rare but serious complication following aortic valve replacement.
  • Limited data exists on PVE incidence and outcomes specifically in low-risk patients undergoing transcatheter aortic valve replacement (TAVR).

Purpose of the Study:

  • To investigate the incidence, causative organisms, clinical course, and outcomes of PVE in low-risk patients after TAVR.
  • To provide crucial data on PVE in a population where such information is currently lacking.

Main Methods:

  • A retrospective review of low-risk patients who underwent TAVR between 2016 and 2020 was conducted.
  • Patients with definitive PVE, as adjudicated by an independent Clinical Events Committee, were analyzed.

Main Results:

  • Out of 396 low-risk patients, 11 developed PVE at a median of 379 days post-TAVR. Incidence was 1.5% within the first year and 2.8% thereafter.
  • Streptococcus was the most common organism. Early PVE (≤365 days) was associated with embolic stroke and re-intervention, while late PVE (>365 days) also frequently caused embolic stroke.
  • Embolic stroke complicated the majority of PVE cases, leading to significant morbidity and mortality, including death, need for rehabilitation, or home care.

Conclusions:

  • Prosthetic valve endocarditis is infrequent but carries substantial morbidity and mortality risks after TAVR in low-risk individuals.
  • Embolic stroke is a major complication of PVE post-TAVR, significantly worsening patient outcomes.
  • Strategies to minimize PVE incidence following TAVR are essential to improve patient prognosis.
Keywords:
aortic valve diseaseendocarditispercutaneous interventionstroketranscatheter valve implantation

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