Infective endocarditis (IE) poses a significant clinical challenge, especially among patients with end-stage renal disease (ESRD) undergoing dialysis, and is associated with high morbidity and mortality rates. This review provides a contemporary discussion of the epidemiology, risk factors, diagnostic challenges, and management strategies for IE among ESRD patients, including a literature review of recent studies focused on this vulnerable population. The review highlights the multifactorial nature of IE risk in ESRD patients, emphasizing the roles of vascular access type, dialysis modality, and comorbid conditions. It also explores the diagnostic utility of different imaging modalities and the importance of a multidisciplinary approach in managing IE, including both medical and surgical interventions. The insights from this review aim to contribute to the improvement of patient outcomes through early recognition, appropriate antimicrobial therapy, and timely surgical intervention when necessary.

Transcatheter aortic valve replacement (TAVR) has been approved for patients with severe symptomatic aortic stenosis (AS) across the spectrum of surgical risk. Although there is substantial evidence regarding the utility of TAVR in patients with classic high-gradient symptomatic AS, the management of patients with discordant AS and gradients that are lower than expected remains uncertain. As low-gradient AS is quite prevalent, it warrants our attention. The TAVR approach in these patients requires risk stratification and additional imaging modalities, such as stress echocardiography, to more accurately evaluate the severity of AS. TAVR complications include stroke, kidney injury, conduction abnormalities, device-related thrombosis, endocarditis, and mechanical or vascular complications, which affect both patients with low- and high-gradient AS (HGAS). Contemporary research has demonstrated that TAVR is more effective in the low-gradient AS population than in the HGAS population and shows better outcomes than conservative management. The management of patients with AS, particularly low-gradient AS, remains poorly understood.