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Infective Endocarditis of Transcatheter Aortic Valve Replacement and Transcatheter Edge-to-Edge Repair Devices
Joe Aoun1, Chloe Kharsa1, Parth Desai1
1Cardiology Department, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.
JACC. Advances
|July 23, 2026
Summary
Infective endocarditis after heart valve procedures is complex. Management requires a team approach, and while advanced imaging helps diagnosis, clear guidelines are needed for treatment, including antimicrobial therapy.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Infective endocarditis is a serious complication after transcatheter aortic valve replacement (TAVR) and transcatheter edge-to-edge repair (TEER).
- Current diagnostic and management strategies for these cases present significant clinical challenges.
- Lack of standardized guidelines complicates treatment decisions, particularly concerning antimicrobial therapy.
Purpose of the Study:
- To review the challenges in diagnosing and managing infective endocarditis post-TAVR and TEER.
- To highlight the role of advanced imaging in improving diagnostic accuracy.
- To identify gaps in current management guidelines, especially regarding antimicrobial suppression therapy.
Main Methods:
- Review of current literature on infective endocarditis following TAVR and TEER.
- Discussion of diagnostic advancements, including 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT).
- Analysis of treatment approaches, including medical management and surgical intervention.
Main Results:
- Infective endocarditis post-TAVR/TEER requires a multidisciplinary approach.
- FDG-PET/CT shows promise for enhanced diagnostic accuracy.
- Standardized management guidelines, particularly for antimicrobial suppression, are currently lacking.
Conclusions:
- Timely diagnosis and multidisciplinary management are crucial for patients with infective endocarditis post-TAVR/TEER.
- Further research is needed to refine diagnostic criteria and optimize therapeutic strategies.
- Improving patient outcomes necessitates standardized guidelines and evidence-based treatment protocols.
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