[I-AEPCJS-04] Infective endocarditis after percutaneous revalvulation of the right ventricular outflow tract and its possible prevention
Percutaneous pulmonary valve implantation has proven good technical feasibility and excellent hemodynamic results for right ventricular outflow tract (RVOT) valve replacement. Infective endocarditis (IE) however is emerging as an important challenge after PPVI causing considerable morbidity and need for re-intervention. Streptococcus and Staphylococcus species are the most frequent causative agents, but many other microorganisms have been reported. Changes in IE epidemiology are of major interest after the guidelines for IE prophylaxis have been restricted from 2007 onwards. S. aureus infections are becoming more frequent due to an increase of medical procedures and subsequent hospitalization while Streptococci remain the most relevant underlying cause of community acquired IE.
Despite advances in medical treatment, IE diagnosis remains challenging and is frequently delayed. As in PPVI it often presents late and is subacute in onset rather than peri-procedural, and clinical symptoms of IE are variable and non-specific. Clinical IE presentations raise the question on specific predictors and risk factors for PPVI IE while data on the subject are still limited.
Novel therapeutic strategies aim to minimize risk factors of IE. Preventive treatment with anti-platelet drugs has been partially introduced in clinical practice while its benefit to reduce the risk of IE remains under discussion. The presentation builds on the clinical expertise gained from diagnosis and treatment of IE patients and aims to link clinical observations with pathophysiological work done by several groups.
Despite advances in medical treatment, IE diagnosis remains challenging and is frequently delayed. As in PPVI it often presents late and is subacute in onset rather than peri-procedural, and clinical symptoms of IE are variable and non-specific. Clinical IE presentations raise the question on specific predictors and risk factors for PPVI IE while data on the subject are still limited.
Novel therapeutic strategies aim to minimize risk factors of IE. Preventive treatment with anti-platelet drugs has been partially introduced in clinical practice while its benefit to reduce the risk of IE remains under discussion. The presentation builds on the clinical expertise gained from diagnosis and treatment of IE patients and aims to link clinical observations with pathophysiological work done by several groups.