biostudies-literatureUnknown6(8)Gurevitz C<h4>Background</h4>Actinomycosis is a chronic invasive infection caused by <i>Actinomyces</i> species. Actinomycosis endocarditis has been described, yet considered rare. We present the first reported transcatheter aortic valve implantation (TAVI)-related actinomycosis endocarditis.<h4>Case summary</h4>A 70-year-old female patient, presented 4 months after TAVI with malaise and vocal-cord paralysis. She underwent computed tomography angiography which demonstrated a 28 mm pseudoaneurysm of the ascending aorta, which compressed the laryngeal nerves. Her condition rapidly deteriorated with cardiogenic shock and required an emergent surgery, which reviled a tamponade with active bleeding, due to an ascending aortic dissection. She underwent aortic valve and ascending aorta replacement. A 2 cm vegetation was found on the TAVI prosthetic valve and sent for cultures, which later revealed an <i>Actinomyces neuii</i> infection. Long-term intravenous ampicillin treatment was given.<h4>Discussion</h4>This case describes a patient with endocarditis on TAVI prosthetic valve, with an unusual clinical presentation and rapid deterioration to an emergency intervention. This unique presentation of tumour-like tissue invasion is characteristic of actinomycosis, and should be suspected especially following valve replacement.European heart journal. Case reportsytac302https://www.ebi.ac.uk/biostudies/studies/S-EPMC9420195biostudies-literatureAn unusual case report of transcatheter aortic valve implantation-related actinomycosis endocarditis.PMC9420195Rubchevsky VGurevitz COrvin KHamdan AfalseAn unusual case report of transcatheter aortic valve implantation-related actinomycosis endocarditis.<h4>Background</h4>Actinomycosis is a chronic invasive infection caused by <i>Actinomyces</i> species. Actinomycosis endocarditis has been described, yet considered rare. We present the first reported transcatheter aortic valve implantation (TAVI)-related actinomycosis endocarditis.<h4>Case summary</h4>A 70-year-old female patient, presented 4 months after TAVI with malaise and vocal-cord paralysis. She underwent computed tomography angiography which demonstrated a 28 mm pseudoaneurysm of the ascending aorta, which compressed the laryngeal nerves. Her condition rapidly deteriorated with cardiogenic shock and required an emergent surgery, which reviled a tamponade with active bleeding, due to an ascending aortic dissection. She underwent aortic valve and ascending aorta replacement. A 2 cm vegetation was found on the TAVI prosthetic valve and sent for cultures, which later revealed an <i>Actinomyces neuii</i> infection. Long-term intravenous ampicillin treatment was given.<h4>Discussion</h4>This case describes a patient with endocarditis on TAVI prosthetic valve, with an unusual clinical presentation and rapid deterioration to an emergency intervention. This unique presentation of tumour-like tissue invasion is characteristic of actinomycosis, and should be suspected especially following valve replacement.2022-01-01T00:00:00Z2022 Aug2025-08-30T03:15:09.591Z2025-04-07T06:48:57.831ZS-EPMC94201953604321110.1093/ehjcr/ytac302