Infective Endocarditis of Transcatheter Aortic Valve Replacement and Transcatheter Edge-to-Edge Repair Devices.
This review addresses infective endocarditis after TAVR and after M-TEER, highlighting the diagnostic role of 18F-FDG PET/CT and the absence of standardized management guidance, particularly around antimicrobial suppression and the threshold for surgical intervention in patients who are not at prohibitive risk.
The authors call for refined diagnostic criteria and better outcome data.
This is a narrative review without new outcome data, and it lands on a genuine evidence gap rather than resolving it.
TAVR-IE and M-TEER-IE remain uncommon but carry high mortality, and the surgical decision is particularly fraught: explantation of a TAVR valve carries reported operative mortality of 12–17%, and no randomized data guide when to operate versus suppress.
Infective endocarditis following transcatheter aortic valve replacement and mitral valve transcatheter edge-to-edge repair poses a significant clinical challenge, necessitating a multidisciplinary approach for timely diagnosis and appropriate management that may include surgical intervention for patients of less than prohibitive risk. Although advances in imaging modalities, including 18F-fluorodeoxyglucose positron emission tomography/computed tomography, show promise in enhancing diagnostic accuracy, standardized guidelines for management are lacking, especially regarding the appropriateness of antimicrobial suppression therapy. Future research should focus on refining diagnostic criteria, optimizing therapeutic strategies, and improving patient outcomes in these populations.
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