TAVI-prosthetic valve endocarditis can often be cured without surgery

Abstract Introduction Prosthetic valve endocarditis (PVE) is the most unfavourable complication after any aortic replacement. Purpose The aim of this study was to analyse impact antibiotic-only and additional surgical therapy in patients with TAVI-PVE compare it results PVE replacement (SAVR) regarding survival. Methods All who underwent primary isolated via SAVR (n=3.447) or TAVI (n=2.269) our heart center between 01/2012–12/2018 were analysed. diagnosis made using 2015 modified Duke criteria. Follow-up performed until 06/2019 (max. 89, mean 34 months) a follow-up rate 98% mortality. Results incidence did not differ significantly 4.9 cases per 100 patient-years 2.4 (p=0.49), although older (mean 80 vs. 67 years) had more multimorbidities (STS score 5.9 1.6) (p<0.001). prostheses polymer showed 4.3-fold higher risk develop than without (p=0.004). Most common pathogens staphylococci enterococci all PVEs. Antibiotic-only resulted better 1-year survival compared (90.9% 33.3%; p=0.005) even 4 an indication for surgery according ESC guidelines. In SAVR-PVE both therapies led comparable (p=0.861). However, operated given by guidelines worse 1 year Conclusion have despite their age greater comorbidities. surgery, if been indicated This new finding presumably due fact that do polymeric suture ring. Our show first time should be carefully. however benefit from guideline-compliant as respect antibiotics-only prognosis. probably related ability gram-positive cocci migrate into ring protect themselves antibiotic forming biofilm. Some newer contain plastic components which can also cured often but are associated increased PVE. Funding Acknowledgement Type funding sources: None.