Infective endocarditis is frequent (12-15 cases/100000) in western countries. According to guidelines, infective endocarditis has an indication for surgical valve replacement in 70% (however, only 50% are operable) with a surgical hospital mortality of up to 20 %. Transcatheter valve replacement with its present technology is absolutely contraindicated in infective endocarditis.

Method and Results: To establish a topical treatment of infected heart valve tissue we developed bioresorbable drug-eluting polymer films, which may be attached to TAVR-systems to allow a topical high concentration antibiotic treatment against Staphylococcus aureus and Enterococcus species, the most frequent bacteria in severe infective endocarditis. We demonstrate that these polymer films may fully eradicate Staphylococcus aureus in pericardium-based biofilms in vitro (untreated: 2.05E+07 ± 1.54E+07 colony-forming units vs. treated: 0,00E+00 ± 0,00E+00 colony-forming units; n=3 each). In vivo testing of the drug-releasing films in subcutaneous staphylococcal infections also fully eradicated the biofilm-embedded bacteria (untreated: 1.16E+05 ± 3,37E+05 colony-forming units/gram tissue; vs. treated: 0,00E+00 ± 0,00E+00 colony-forming units/gram tissue; n=3).

Conclusion: The development of drug-eluting polymer films attached to TAVR-systems might allow an efficient topical treatment of IE and consequently extend drug-eluting TAVR systems to treat IE circumventing high-risk SVR interventions in future. This might reduce the high hospital mortality of IE.