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Войти в исследования JACC. Case reports · 2026
Fatal Prosthetic Valve Endocarditis After Transcatheter Tricuspid Valve Replacement: Specialist Cardiac Autopsy Findings.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Panday Samuel Rustem, Eskandari Mehdi, Papachristidis Alexandros, Simpson Rupert, Chan Tsz Ho, MacCarthy Philip, Sheppard Mary N, Byrne Jonathan
Аннотация
BACKGROUND: Transcatheter tricuspid valve replacement (TTVR) is an emerging therapy for severe tricuspid regurgitation with an evolving complication profile. Fatal prosthetic valve endocarditis (PVE) following orthotopic TTVR appears exceptionally rare, with detailed pathologic description through specialist cardiovascular autopsy remaining limited.
CASE SUMMARY: A 65-year-old man with severe functional tricuspid regurgitation and persistent atrial fibrillation underwent TTVR. The following day, he developed complete heart block requiring pacemaker implantation. He remained well at 1 and 3 months, with improving symptoms and unremarkable bloods. At 6 months, he developed nonspecific viral-like symptoms over 48 hours culminating in death at home. Routine postmortem examination attributed death to coronary artery disease. Specialist cardiovascular pathology demonstrated PVE with large vegetations, atrioventricular nodal obliteration, left atrial communication enabling systemic septic embolization, diffuse coronary microembolization, and widespread left ventricular microabscesses.
DISCUSSION: Fatal PVE after TTVR may present with nonspecific prodromal symptoms. Unexplained death after transcatheter valve intervention warrants specialist cardiovascular pathology.
TAKE HOME MESSAGE: Prosthetic valve endocarditis after transcatheter tricuspid valve replacement may present with nonspecific symptoms and rapid clinical deterioration; unexplained death should prompt specialist cardiovascular pathology.
CASE SUMMARY: A 65-year-old man with severe functional tricuspid regurgitation and persistent atrial fibrillation underwent TTVR. The following day, he developed complete heart block requiring pacemaker implantation. He remained well at 1 and 3 months, with improving symptoms and unremarkable bloods. At 6 months, he developed nonspecific viral-like symptoms over 48 hours culminating in death at home. Routine postmortem examination attributed death to coronary artery disease. Specialist cardiovascular pathology demonstrated PVE with large vegetations, atrioventricular nodal obliteration, left atrial communication enabling systemic septic embolization, diffuse coronary microembolization, and widespread left ventricular microabscesses.
DISCUSSION: Fatal PVE after TTVR may present with nonspecific prodromal symptoms. Unexplained death after transcatheter valve intervention warrants specialist cardiovascular pathology.
TAKE HOME MESSAGE: Prosthetic valve endocarditis after transcatheter tricuspid valve replacement may present with nonspecific symptoms and rapid clinical deterioration; unexplained death should prompt specialist cardiovascular pathology.