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- Title
Prosthetic Valve Endocarditis with Valvular Obstruction.
- Authors
Pabilona, Christine; Gitler, Bernard; Lederman, Jeffrey A.; Miller, Donald; Keltz, Theodore N.
- Abstract
Patients with severe aortic stenosis who are at high risk for open-heart surgery might be candidates for transcatheter aortic valve replacement (TAVR). To our knowledge, this is the first report of Streptococcus viridans endocarditis that caused prosthetic valve obstruction after TAVR. A 77-year-old man who had undergone TAVR 17 months earlier was admitted because of evidence of prosthetic valve endocarditis. A transthoracic echocardiogram revealed a substantial increase in the transvalvular peak gradient and mean gradient in comparison with an echocardiogram of 7 months earlier. A transesophageal echocardiogram showed a 1.5-cm vegetation obstructing the valve. Blood cultures yielded penicillin-sensitive S. viridans. The patient was hemodynamically stable and was initially treated with vancomycin because of his previous penicillin allergy. Subsequent therapy with levofloxacin, oral penicillin (after a negative penicillin skin test), and intravenous penicillin eliminated the symptoms of the infection. Transcatheter aortic valve replacement is a relatively new procedure, and sequelae are still being discovered. We recommend that physicians consider obstructive endocarditis as one of these.
- Subjects
ENDOCARDITIS; ENDOCARDIUM diseases; INFLAMMATION; INFECTIVE endocarditis; ANTIBACTERIAL agents
- Publication
Texas Heart Institute Journal, 2015, Vol 42, Issue 2, p172
- ISSN
1526-6702
- Publication type
Article
- DOI
10.14503/THIJ-13-3961