Infective Endocarditis After Transcatheter Aortic Valve Implantation: Current Challenges in Diagnosis, Management,...

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Devices

Background:

• Transcatheter aortic valve implantation (TAVI) use is increasing globally due to aging populations and cost-effectiveness.
• This rise is associated with a growing incidence of TAVI-related infective endocarditis (IE).
• TAVI-associated IE presents unique epidemiological features, including a higher frequency of enterococcal infections in older patients with comorbidities.

Purpose of the Study:

• To highlight the challenges in diagnosing and managing TAVI-associated infective endocarditis.
• To emphasize the importance of advanced imaging in diagnosis and treatment planning.
• To discuss current treatment strategies and the need for improved prevention and research.

Main Methods:

• Review of current literature on TAVI-associated infective endocarditis.
• Discussion of diagnostic modalities including echocardiography, CT, and PET/CT.
• Analysis of treatment approaches, including surgical indications and antibiotic therapy.

Main Results:

• Diagnosing TAVI-IE requires high clinical suspicion and advanced imaging for accurate assessment.
• Surgical explantation of TAVI devices presents unique challenges.
• Individualized antibiotic regimens are crucial for patients unsuitable for surgery.

Conclusions:

• TAVI-associated endocarditis is a growing concern requiring specialized management.
• Further collaborative research, including randomized studies, is essential to optimize prevention and treatment strategies.
• Current prophylactic antibiotic recommendations require stronger evidence.