LAUSR

Ever since the introduction and surgical success of Starr–Edwards prostheses for valve replacement in the 1960s, prosthetic valve endocarditis (PVE) has plagued us. In the early 1970s, reports proliferated describing PVE and its complications, and the concept of “early” and “late” PVE took shape. It became apparent that “early” PVE was generally due to infections related to the surgery itself or its attendant hospital stay. The organisms responsible were often Gram‐positive or Gram‐negative bad actors (staph and Pseudomonas) that were aggressive and/or antibiotic resistant, leading to poor outcomes. “Late” PVE that appeared months after surgery was often caused by more susceptible organisms that we associate with “subacute” endocarditis, such as streptococcus viridans. Intravenous antibiotic therapy and often surgical intervention was standard, but outcomes were never terrific. Fast forward to the report in this issue of CCI by Ogami and colleagues that used the National Readmission Database to chronicle patients that underwent transcatheter aortic valve replacement