Table 2. Suggested infection control measures before TAVI procedure.

Infrastructure	Patient preparation	Staff
Cardiac catheterisation laboratory or hybrid operating theatre	Shower preferably with chlorhexidine soap before the intervention If the patient is known to be a S. aureus carrier or has a body mass index >30 kg/m² and suffers from diabetes mellitus, decolonisation with nasal mupirocin ointment for 5 days may be considered	Surgical hand hygiene Sterile gown and gloves Surgical mask and hood
Clean room air	Hair removal with clippers before intervention if needed	Change gloves or remove outer gloves in “double gloving” before having contact with the unpacked TAVI prosthesis
Minimal traffic in the cardiac catheterisation laboratory or hybrid operating theatre	Peri-interventional skin disinfection according to surgical standards: three applications of an alcohol-based disinfectant with a remanent supplement (e.g., chlorhexidine or povidone-iodine)
Closed doors of cardiac catheterisation laboratory or hybrid operating theatre	Antimicrobial prophylaxis 0-120 minutes (preferably 0-60 minutes) before arterial puncture with a single dose& of, e.g., IV amoxicillin/clavulanic acid¥ 2.2 grams Beta-lactam allergy or settings with a high prevalence of methicillin-resistant staphylococci#: single dose of IV vancomycin 15 mg/kg* or IV teicoplanin 9-12 mg/kg
Minimal exposure time to ambient air of unpacked TAVI prosthesisΩ
Ω Whenever possible, an exposure time below 15 minutes should be targeted. & In case procedure takes longer than two hours, a second dose of IV amoxicillin/clavulanic acid 2.2 grams should be administered. ¥ Alternatively, single dose& of IV ampicillin/sulbactam 3 grams can be used. * Slow infusion time over one hour to avoid “red man syndrome”, start two hours before intervention to reach high enough tissue drug levels at the time of TAVI. # When using a glycopeptide in settings with a high prevalence of methicillin-resistant staphylococci, a first- or second-generation cephalosporin (e.g., cefazolin 2 grams or cefuroxime 1.5 grams) is preferably added. IV: intravenous