Endocarditis after transfemoral aortic valve implantation in a patient with Osler-Weber-Rendu syndrome

Transcatheter aortic valve implantation (TAVI) was introduced five years ago (2007) as an alternative treatment for patients with severe aortic stenosis, who are considered at too high a risk for surgical replacement. Few cases of postoperative infection by TAVI device are reported in the literature. We report the case of a patient with Osler-Weber-Rendu (OWR) syndrome, in which the TAVI procedure was preferred at the outset to avoid the risk of bleeding. He was diagnosed with endocarditis on the TAVI device one year later; he then underwent an uneventful surgical aortic valve replacement. In these complex clinical cases it is difficult to determine a 'gold standard' treatment and the possibility of offering patients both the percutaneous treatment and the surgical replacement appears to be desirable. Correction of the valve disease improves the outcome, reducing the episodes of haemorrhage and the need for blood transfusions.