Successful Surgical Therapy of a Chronically Infected Thoracic Fistula After Repeated Cardiovascular High-Risk Procedures.

Chronic thoracic fistulas after transapical TAVI are rare but serious complications. A 67-year-old male with prior aortic dissection and two transapical valve implantations developed a chronically infected fistula due to retained apical closure material. Multidisciplinary surgery with complete removal of infected tissue, staged debridement, vacuum-assisted closure (VAC) therapy, and targeted antibiotics achieved infection control and successful wound reconstruction using local flaps. The patient recovered uneventfully. Complete foreign material removal and interdisciplinary management are crucial for durable healing in high-risk posttransapical TAVI patients.