Related Experiment Video
Updated: Oct 13, 2025
08:42
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
3.7K
Recurrent Multivalvular Staphylococcus Lugdunensis Endocarditis Causing Complete Heart Block after TAVR
Preeti Singhal1,2, Somsupha Kanjanauthai2,3, Wilson Kwan2,3
1Department of Internal Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA.
Case Reports in Cardiology
|November 11, 2021
Summary
Prosthetic valve endocarditis after transcatheter aortic valve replacement (PVE after TAVR) can be severe and caused by uncommon organisms like Staphylococcus lugdunensis. Early surgery is crucial for PVE after TAVR, especially with heart block.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Transcatheter aortic valve replacement (TAVR) is a key treatment for severe aortic stenosis.
- Prosthetic valve endocarditis (PVE) is a serious complication following TAVR.
- Diagnosing PVE after TAVR can be challenging, particularly with atypical presentations.
Observation:
- A 78-year-old female developed PVE after TAVR, presenting with fever, syncope, and complete heart block.
- Blood cultures identified Staphylococcus lugdunensis, an uncommon but virulent pathogen.
- Transesophageal echocardiogram revealed vegetations on multiple valves and aorto-mitral continuity.
Findings:
- The patient required emergent surgery due to cardiac arrest.
- Surgical intervention included TAVR explantation, valve replacements, tricuspid valve repair, and coronary artery endarterectomy.
- Staphylococcus lugdunensis demonstrated virulence by affecting both native and prosthetic valves.
Implications:
- PVE after TAVR necessitates a high clinical suspicion, especially in patients with conduction abnormalities.
- Early surgical intervention is critical for PVE after TAVR complicated by heart block, abscesses, or destructive lesions.
- This case highlights the importance of prompt diagnosis and management of PVE after TAVR to improve patient outcomes.
Related Concept Videos
01:25Endocarditis I: Introduction
60
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
60
01:18Endocarditis III: Medical Management
44
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
44
01:22Mitral Stenosis I: Introduction
80
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
80
01:26Mitral Stenosis III: Medical Management
42
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
42
01:25Endocarditis II: Clinical Features of Infective Endocarditis
46
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
46
01:23Rheumatic Heart Disease I: Introduction
90
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
90