AI Article Synopsis
- Advances in interventional cardiology have led to increased use of cardiac devices, resulting in more cases of device-associated endocarditis, a serious condition with complex treatment challenges.
- The case of an 83-year-old woman illustrates the risks, as she developed endocarditis linked to her left atrial appendage closure device 20 months post-procedure, leading to her eventual death despite antibiotic treatment.
- The report highlights the rarity of LAA closure device-associated endocarditis but notes that as these devices become more common, healthcare professionals should anticipate an increase in such infections, emphasizing the need for accurate diagnostic methods like transoesophageal echocardiography.
Article Abstract
Background: Due to advances in interventional cardiology in recent years, more and more patients are currently receiving cardiac devices, with a subsequent increase in the number of patients with device-associated endocarditis. Device-associated endocarditis is a life-threatening disease with special diagnostic and therapeutic challenges. Interventional devices for left atrial appendage (LAA) closure have been available for several years. However, there have been very few case reports of LAA closure device-associated endocarditis.
Case Summary: An 83-year-old woman presented with fever and fatigue. She had a history of permanent atrial fibrillation and recurrent bleeding on oral anticoagulation. Consequently, the patient underwent interventional LAA closure ∼20 months earlier. Blood cultures grew . Transoesophageal echocardiography revealed an LAA closure device-associated mobile, echo-dense mass that was consistent with infectious vegetation in this clinical context. Intravenous antibiotic therapy was started, and our heart team recommended complete removal of the device, which the patient refused. The patient subsequently died as a result of progressive endocarditis and multiple pre-existing co-morbidities.
Discussion: Left atrial appendage occlusion device-associated endocarditis has rarely been reported. Due to the increase in LAA closure device implantation, device-associated endocarditis is expected to increase in the future. Transoesophageal echocardiography is required for correct diagnosis. Our case report suggests that an infection can occur long after implantation.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675590 | PMC |
| http://dx.doi.org/10.1093/ehjcr/ytac434 | DOI Listing |
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