Transcatheter aortic valve implantation in a patient with extreme risk of development of infective endocarditis

Aortic stenosis is the most common acquired valvular heart disease by adults and due to aging of population prevalence will increase. Since 2002 transcatheter aortic valve implantation (TAVI) has become a well-recognized alternative for surgical aortic valve replacement (SAVR). Initially for inoperable patients or the high surgical risk patients, later even for the patients with medium and low risk. It all relates with technological progress of the method and increasing experience of cardiac centers. As invasive procedure, it has its own complications, including prosthetic infective endocarditis (TAVI-IE) with the incidence 0.3-3.4% and mortality up to 67% within 2 years after the diagnosis. That is why the preoperative screening and curing of active infectious focuses is absolutely necessary. Our case report of a patient with symptomatic severe aortic stenosis and infected venous leg ulcers, which are a source of bacteremia with potential development of TAVI-IE, shows the necessity of multidisciplinary cooperation as well as an individualized approach and further thorough patient's monitoring after TAVI.