The interventional treatment of aortic stenosis is currently based on transcatheter aortic valve implantation/replacement (TAVI/TAVR) and surgical aortic valve replacement (SAVR). Prosthetic valve infective endocarditis (PVE) is the most worrisome complication after valve replacement, as it still carries high mortality and morbidity rate. Studies have not highlighted the differences in the occurrence of PVE in SAVR as opposed to TAVR, but the reported incidence rates are widely uneven. Literature portrays different microbiological profiles for SAVR and TAVR PVE: Staphylococcus, Enterococcus, and Streptococcus are the pathogens that are more frequently involved with differences regarding the timing from the date of the intervention. Imaging by means of transoesophageal echocardiography, and computed tomography (CT) Scan is essential in identifying vegetations, prosthesis dysfunction, dehiscence, periannular abscess, or aorto-ventricular discontinuity. In most cases, conservative medical treatment is not able to prevent fatal events and surgery represents the only viable option. The primary objectives of surgical treatment are radical debridement and the removal of infected tissues, the reconstruction of cardiac and aortic morphology, and the restoration of the aortic valve function. Different surgical options are discussed. Fast diagnosis, the adequacy of antibiotics treatment, and prompt interventions are essential in preventing the negative consequences of infective endocarditis (IE).

中文翻译：

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主动脉瓣假体患者的心内膜炎：手术和经导管假体的比较

主动脉瓣狭窄的介入治疗目前基于经导管主动脉瓣植入/置换（TAVI / TAVR）和外科主动脉瓣置换（SAVR）。人工瓣膜感染性心内膜炎（PVE）是置换瓣膜后最令人担忧的并发症，因为它仍然具有很高的死亡率和发病率。研究没有强调SAVR与TAVR相比PVE发生的差异，但报道的发病率差异很大。文献描述了SAVR和TAVR PVE的不同微生物学特征：葡萄球菌，肠球菌和链球菌是更常见的病原体，涉及从干预日期算起的时间差异。经食道超声心动图成像 计算机断层扫描（CT）扫描对于识别植被，假体功能障碍，裂开，肛门周围脓肿或主动脉室不连续至关重要。在大多数情况下，保守的药物治疗无法预防致命事件，因此手术是唯一可行的选择。外科治疗的主要目标是根治性清创术和感染组织的清除，心脏和主动脉形态的重建以及主动脉瓣功能的恢复。讨论了不同的手术选择。快速诊断，适当的抗生素治疗和及时的干预措施对于预防感染性心内膜炎（IE）的不良后果至关重要。保守的医学治疗无法预防致命事件，因此手术是唯一可行的选择。外科治疗的主要目标是根治性清创术和感染组织的清除，心脏和主动脉形态的重建以及主动脉瓣功能的恢复。讨论了不同的手术选择。快速诊断，适当的抗生素治疗和及时的干预措施对于预防感染性心内膜炎（IE）的不良后果至关重要。保守的医学治疗无法预防致命事件，因此手术是唯一可行的选择。外科治疗的主要目标是根治性清创术和感染组织的清除，心脏和主动脉形态的重建以及主动脉瓣功能的恢复。讨论了不同的手术选择。快速诊断，适当的抗生素治疗和及时的干预措施对于预防感染性心内膜炎（IE）的不良后果至关重要。讨论了不同的手术选择。快速诊断，适当的抗生素治疗和及时的干预措施对于预防感染性心内膜炎（IE）的不良后果至关重要。讨论了不同的手术选择。快速诊断，适当的抗生素治疗和及时的干预措施对于预防感染性心内膜炎（IE）的不良后果至关重要。