1. Infective Endocarditis Following Transcatheter Aortic Valve Replacement: Comparison of Balloon- Versus Self-Expandable Valves.
- Author
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Regueiro A, Linke, Latib, Ihlemann, Urena, Walther, Husser, Herrmann C, Nombela-Franco, Cheema, Le Breton H, Stortecky, Kapadia, Bartorelli L, Sinning, Amat-Santos, Munoz-Garcia J, Lerakis, Gutíerrez-Ibanes, Abdel-Wahab, Tchetche, Testa, Eltchaninoff, Livi, Castillo, Jilaihawi, Webb G, Barbanti M, Kodali, de Brito Jr S, Ribeiro B, Miceli, Fiorina, Actis Dato, Rosato F, Serra, Masson, Wijeysundera C, Mangione A, Ferreira, Lima C, Carvalho A, Abizaid, Marino A, Esteves, Andrea C.M., Messika-Zeitoun, Himbert, Kim, Pellegrini, Auffret, Nietlispach, Pilgrim, Durand, Lisko, Makkar R, Lemos, Leon B, Puri, San Roman, Vahanian, Søndergaard, Mangner, and Rodés-Cabau
- Subjects
- Aged, Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve Stenosis diagnostic imaging, Clinical Decision-Making, Device Removal, Endocarditis, Bacterial microbiology, Endocarditis, Bacterial mortality, Endocarditis, Bacterial surgery, Female, Humans, Incidence, Male, Patient Selection, Prosthesis Design, Prosthesis-Related Infections microbiology, Prosthesis-Related Infections mortality, Prosthesis-Related Infections surgery, Registries, Reoperation, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Aortic Valve surgery, Aortic Valve Stenosis surgery, Balloon Valvuloplasty, Endocarditis, Bacterial epidemiology, Heart Valve Prosthesis, Prosthesis-Related Infections epidemiology, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation
- Abstract
Background: No data exist about the characteristics of infective endocarditis (IE) post-transcatheter aortic valve replacement (TAVR) according to transcatheter valve type. We aimed to determine the incidence, clinical characteristics, and outcomes of patients with IE post-TAVR treated with balloon-expandable valve (BEV) versus self-expanding valve (SEV) systems., Methods: Data from the multicenter Infectious Endocarditis After TAVR International Registry was used to compare IE patients with BEV versus SEV., Results: A total of 245 patients with IE post-TAVR were included (SEV, 47%; BEV, 53%). The timing between TAVR and IE was similar between groups (SEV, 5.5 [1.2-15] months versus BEV, 5.3 [1.7-11.4] months; P =0.89). Enterococcal IE was more frequent in the SEV group (36.5% versus 15.4%; P <0.01), and vegetation location differed according to valve type (stent frame, SEV, 18.6%; BEV, 6.9%; P =0.01; valve leaflet, SEV, 23.9%; BEV, 38.5%; P =0.01). BEV recipients had a higher rate of stroke/systemic embolism (20.0% versus 8.7%, adjusted OR: 2.46, 95% CI: 1.04-5.82, P =0.04). Surgical explant of the transcatheter valve (SEV, 8.7%; BEV, 13.8%; P =0.21), and in-hospital death at the time of IE episode (SEV, 35.6%; BEV, 37.7%; P =0.74) were similar between groups. After a mean follow-up of 13±12 months, 59.1% and 54.6% of the SEV and BEV recipients, respectively, had died ( P =0.66)., Conclusions: The characteristics of IE post-TAVR, including microorganism type, vegetation location, and embolic complications but not early or late mortality, differed according to valve type. These results may help to guide the diagnosis and management of IE and inform future research studies in the field.
- Published
- 2019
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