• Transcatheter Aortic Valve Replacement
• Endocarditis
• Coronary Angiography
• Heart Valve Prosthesis Implantation

Since the first implementation in 2002 by Alain Cribier, transcatheter aortic valve replacement (TAVR) has become a standard procedure for high-risk and elderly patients with severe aortic valve stenosis. Recently, the use of TAVR has expanded to relatively younger patients with low to moderate surgical risk. Infective endocarditis (IE) after TAVR, first reported in medical literature in 2010, is a relatively new and extremely concerning complication.1 Its incidence, reported as 1.1% per person-year based on a large international registry, is similar to that observed in surgical aortic valve replacement (SAVR), despite the latter involving much larger skin incisions and greater internal tissue exposure.2 On the one hand, this fact underscores that the development of IE is influenced not only by the iatrogenic introduction of bacteria but also by the increased risk associated with implanted foreign material. On the other hand, TAVR patients are older, have an increased frailty and an increased likelihood of subsequent procedures, such as pacemaker implantation. IE after TAVR remains a serious and potentially fatal condition, with in-hospital and 1-year mortality rates of 31.8% and 44.8%, respectively.3

While the incidence of bacteraemia after TAVR has been assessed by few studies, it is clinically significant as a natural precursor to IE. The prevention of bacteraemia and IE after TAVR has traditionally found its foundations on the well-described risk of these complications and its spectrum of pathogens after SAVR. Recently emerging studies suggest that the pathogens causing infectious complications after TAVR differ from those after SAVR. In fact, the …