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1. Infective Endocarditis Caused by Staphylococcus aureus After Transcatheter Aortic Valve Replacement.

Author: UCL - (SLuc) Département cardiovasculaire, UCL - SSS/IREC/SLUC - Pôle St.-Luc, Del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Vendramin, Igor, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria-Cristina, Corriea de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R, Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S, Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, Rodés-Cabau, Josep, UCL - (SLuc) Département cardiovasculaire, UCL - SSS/IREC/SLUC - Pôle St.-Luc, Del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Vendramin, Igor, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria-Cristina, Corriea de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R, Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S, Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, and Rodés-Cabau, Josep
Abstract: Staphylococcus aureus (SA) has been extensively studied as causative microorganism of surgical prosthetic-valve infective endocarditis (IE). However, scarce evidence exists on SA IE after transcatheter aortic valve replacement (TAVR). Data were obtained from the Infectious Endocarditis After TAVR International Registry, including patients with definite IE after TAVR from 59 centres in 11 countries. Patients were divided into 2 groups according to microbiologic etiology: non-SA IE vs SA IE. SA IE was identified in 141 patients out of 573 (24.6%), methicillin-sensitive SA in most cases (115/141, 81.6%). Self-expanding valves were more common than balloon-expandable valves in patients presenting with early SA IE. Major bleeding and sepsis complicating TAVR, neurologic symptoms or systemic embolism at admission, and IE with cardiac device involvement (other than the TAVR prosthesis) were associated with SA IE (P < 0.05 for all). Among patients with IE after TAVR, the likelihood of SA IE increased from 19% in the absence of those risk factors to 84.6% if ≥ 3 risk factors were present. In-hospital (47.8% vs 26.9%; P < 0.001) and 2-year (71.5% vs 49.6%; P < 0.001) mortality rates were higher among patients with SA IE vs non-SA IE. Surgery at the time of index SA IE episode was associated with lower mortality at follow-up compared with medical therapy alone (adjusted hazard ratio 0.46, 95% CI 0.22-0.96; P = 0.038). SA IE represented approximately 25% of IE cases after TAVR and was associated with very high in-hospital and late mortality. The presence of some features determined a higher likelihood of SA IE and could help to orientate early antibiotic regimen selection. Surgery at index SA IE was associated with improved outcomes, and its role should be evaluated in future studies.
Published: 2022

2. Mitral Valve Infective Endocarditis after Trans-Catheter Aortic Valve Implantation.

Author: UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Département cardiovasculaire, Panagides, Vassili, Del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Scislo, Piotr, Huczek, Zenon, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Kim, Won-Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, Brito, Fabio Sandoli de, Dato, Guglielmo Mario Actis, Rosato, Francesco, Ferreira, Maria-Cristina, de Lima, Valter Correia, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R, Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Breton, Hervé Le, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S, Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, Rodés-Cabau, Josep, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Département cardiovasculaire, Panagides, Vassili, Del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Scislo, Piotr, Huczek, Zenon, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Kim, Won-Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, Brito, Fabio Sandoli de, Dato, Guglielmo Mario Actis, Rosato, Francesco, Ferreira, Maria-Cristina, de Lima, Valter Correia, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R, Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Breton, Hervé Le, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S, Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, and Rodés-Cabau, Josep
Abstract: Scarce data exist on mitral valve (MV) infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). This multicenter study included a total of 579 patients with a diagnosis of definite IE after TAVI from the IE after TAVI International Registry and aimed to evaluate the incidence, characteristics, management, and outcomes of MV-IE after TAVI. A total of 86 patients (14.9%) had MV-IE. These patients were compared with 284 patients (49.1%) with involvement of the transcatheter heart valve (THV) only. Two factors were found to be associated with MV-IE: the use of self-expanding valves (adjusted odds ratio 2.49, 95% confidence interval [CI] 1.23 to 5.07, p = 0.012), and the presence of an aortic regurgitation ≥2 at discharge (adjusted odds ratio 3.33; 95% CI 1.43 to 7.73, p <0.01). There were no differences in IE timing and causative microorganisms between groups, but surgical management was significantly lower in patients with MV-IE (6.0%, vs 21.6% in patients with THV-IE, p = 0.001). All-cause mortality rates at 2-year follow-up were high and similar between patients with MV-IE (51.4%, 95% CI 39.8 to 64.1) and patients with THV-IE (51.5%, 95% CI 45.4 to 58.0) (log-rank p = 0.295). The factors independently associated with increased mortality risk in patients with MV-IE were the occurrence of heart failure (adjusted p <0.001) and septic shock (adjusted p <0.01) during the index hospitalization. One of 6 IE episodes after TAVI is localized on the MV. The implantation of a self-expanding THV and the presence of an aortic regurgitation ≥2 at discharge were associated with MV-IE. Patients with MV-IE were rarely operated on and had a poor prognosis at 2-year follow-up.
Published: 2022

3. Surgical Treatment of Patients With Infective Endocarditis After Transcatheter Aortic Valve Implantation.

Author: UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Département cardiovasculaire, Mangner, Norman, del Val, David, Abdel-Wahab, Mohamed, Crusius, Lisa, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Kim, Won-Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria-Cristina, Correia de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R, Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S, Boukhris, Marouane, Gervais, Philippe, Côté, Mélanie, Holzhey, David, Linke, Axel, Rodés-Cabau, Josep, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Département cardiovasculaire, Mangner, Norman, del Val, David, Abdel-Wahab, Mohamed, Crusius, Lisa, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Kim, Won-Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria-Cristina, Correia de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R, Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S, Boukhris, Marouane, Gervais, Philippe, Côté, Mélanie, Holzhey, David, Linke, Axel, and Rodés-Cabau, Josep
Abstract: The optimal treatment of patients developing infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) is uncertain. The goal of this study was to investigate the clinical characteristics and outcomes of patients with TAVI-IE treated with cardiac surgery and antibiotics (IE-CS) compared with patients treated with antibiotics alone (IE-AB). Crude and inverse probability of treatment weighting analyses were applied for the treatment effect of cardiac surgery vs medical therapy on 1-year all-cause mortality in patients with definite TAVI-IE. The study used data from the Infectious Endocarditis after TAVI International Registry. Among 584 patients, 111 patients (19%) were treated with IE-CS and 473 patients (81%) with IE-AB. Compared with IE-AB, IE-CS was not associated with a lower in-hospital mortality (HR: 0.85; 95% CI: 0.58-1.25) and 1-year all-cause mortality (HR: 0.88; 95% CI: 0.64-1.22) in the crude cohort. After adjusting for selection and immortal time bias, IE-CS compared with IE-AB was also not associated with lower mortality rates for in-hospital mortality (HR: 0.92; 95% CI: 0.80-1.05) and 1-year all-cause mortality (HR: 0.95; 95% CI: 0.84-1.07). Results remained similar when patients with and without TAVI prosthesis involvement were analyzed separately. Predictors for in-hospital and 1-year all-cause mortality included logistic EuroSCORE I, Staphylococcus aureus, acute renal failure, persistent bacteremia, and septic shock. In this registry, the majority of patients with TAVI-IE were treated with antibiotics alone. Cardiac surgery was not associated with an improved all-cause in-hospital or 1-year mortality. The high mortality of patients with TAVI-IE was strongly linked to patients' characteristics, pathogen, and IE-related complications.
Published: 2022

4. Running Away from the War in Ukraine: The Impact on Mental Health of Internally Displaced Persons (IDPs) and Refugees in Transit in Poland

Author: Rizzi, Damiano, Ciuffo, Giulia, Sandoli, Giulia, Mangiagalli, Matteo, de Angelis, Pietro, Scavuzzo, Gioele, Nych, Mariana, Landoni, Marta, Ionio, Chiara, Ciuffo, Giulia (ORCID:0000-0003-4031-0890), Landoni, Marta (ORCID:0000-0003-0082-1565), Ionio, Chiara (ORCID:0000-0002-0163-3841), Rizzi, Damiano, Ciuffo, Giulia, Sandoli, Giulia, Mangiagalli, Matteo, de Angelis, Pietro, Scavuzzo, Gioele, Nych, Mariana, Landoni, Marta, Ionio, Chiara, Ciuffo, Giulia (ORCID:0000-0003-4031-0890), Landoni, Marta (ORCID:0000-0003-0082-1565), and Ionio, Chiara (ORCID:0000-0002-0163-3841)
Abstract: A growing body of research highlights how communities traumatized by conflict and displacement suffer from long-term mental and psychosocial illnesses. The Russian army's attack on Ukraine has resulted in an estimated 10 million people being internally or externally displaced from Ukraine, of whom more than 3.8 million have left Ukraine to seek refuge elsewhere in Europe. Soleterre has decided to launch an intervention to provide psychological support to Ukrainian refugees and IDPs, aimed at containing war trauma, assessing the severity of symptoms, and enabling those affected to receive psychological support. The intervention model envisioned the administration of an intake form to provide a rapid collection of qualitative and quantitative information for those arriving in Poland or Lviv from Ukraine. Our results showed how most of the samples reported high or very high levels of anxiety, depression, and sleep disturbances. Moreover, results highlighted how being close to families or being able to keep in touch with them work as a protective factor in enhancing resilience, as well as a support network. These findings underscored the importance of re-thinking our perception of "family" in a broader sense, considering the new facets it can take on in post-conflict situations.
Published: 2022

5. Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement

Author: Panagides, Vassili, Del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N., Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C., Testa, Luca, Kim, Won Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L., Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C., Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B., Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria Cristina, Correia de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G., Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, Rodés-Cabau, Josep, Panagides, Vassili, Del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N., Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C., Testa, Luca, Kim, Won Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L., Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C., Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B., Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria Cristina, Correia de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G., Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, and Rodés-Cabau, Josep
Abstract: BACKGROUND: Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients. METHODS: This multicenter study included 579 patients who had the diagnosis of definite IE at a median of 171 (53-421) days following TAVR. PEE was defined as the presence of an intracardiac abscess, pseudoaneurysm, or fistula. RESULTS: A total of 105 patients (18.1%) were diagnosed with PEE (perivalvular abscess, pseudoaneurysm, fistula, or a combination in 87, 7, 7, and 4 patients, respectively). A history of chronic kidney disease (adjusted odds ratio [ORadj], 2.08; 95% confidence interval [CI]: 1.27-3.41; P = .003) and IE secondary to coagulase-negative staphylococci (ORadj, 2.71; 95% CI: 1.57-4.69; P < .001) were associated with an increased risk of PEE. Surgery was performed at index IE episode in 34 patients (32.4%) with PEE (vs 15.2% in patients without PEE, P < .001). In-hospital and 2-year mortality rates among PEE-IE patients were 36.5% and 69.4%, respectively. Factors independently associated with an increased mortality were the occurrence of other complications (stroke post-TAVR, acute renal failure, septic shock) and the lack of surgery at index IE hospitalization (padj < 0.05 for all). CONCLUSIONS: PEE occurred in about one-fifth of IE post-TAVR patients, with the presence of coagulase-negative staphylococci and chronic kidney disease determining an increased risk. Patients with PEE-IE exhibited high early and late mortality rates, and surgery during IE hospitalization seemed to be associated with better outcomes.
Published: 2022

6. Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement

Author: Panagides, Vassili, Del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N., Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C., Testa, Luca, Kim, Won Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L., Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C., Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B., Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria Cristina, Correia de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G., Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, Rodés-Cabau, Josep, Panagides, Vassili, Del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N., Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C., Testa, Luca, Kim, Won Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L., Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C., Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B., Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria Cristina, Correia de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G., Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, and Rodés-Cabau, Josep
Abstract: BACKGROUND: Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients. METHODS: This multicenter study included 579 patients who had the diagnosis of definite IE at a median of 171 (53-421) days following TAVR. PEE was defined as the presence of an intracardiac abscess, pseudoaneurysm, or fistula. RESULTS: A total of 105 patients (18.1%) were diagnosed with PEE (perivalvular abscess, pseudoaneurysm, fistula, or a combination in 87, 7, 7, and 4 patients, respectively). A history of chronic kidney disease (adjusted odds ratio [ORadj], 2.08; 95% confidence interval [CI]: 1.27-3.41; P = .003) and IE secondary to coagulase-negative staphylococci (ORadj, 2.71; 95% CI: 1.57-4.69; P < .001) were associated with an increased risk of PEE. Surgery was performed at index IE episode in 34 patients (32.4%) with PEE (vs 15.2% in patients without PEE, P < .001). In-hospital and 2-year mortality rates among PEE-IE patients were 36.5% and 69.4%, respectively. Factors independently associated with an increased mortality were the occurrence of other complications (stroke post-TAVR, acute renal failure, septic shock) and the lack of surgery at index IE hospitalization (padj < 0.05 for all). CONCLUSIONS: PEE occurred in about one-fifth of IE post-TAVR patients, with the presence of coagulase-negative staphylococci and chronic kidney disease determining an increased risk. Patients with PEE-IE exhibited high early and late mortality rates, and surgery during IE hospitalization seemed to be associated with better outcomes.
Published: 2022

7. Infective Endocarditis Caused by Staphylococcus aureus After Transcatheter Aortic Valve Replacement

Author: del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Vendramin, Igor, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria-Cristina, Corriea de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, Rodés-Cabau, Josep, del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Vendramin, Igor, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria-Cristina, Corriea de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, and Rodés-Cabau, Josep
Abstract: Background: Staphylococcus aureus (SA) has been extensively studied as causative microorganism of surgical prosthetic-valve infective endocarditis (IE). However, scarce evidence exists on SA IE after transcatheter aortic valve replacement (TAVR). Methods: Data were obtained from the Infectious Endocarditis After TAVR International Registry, including patients with definite IE after TAVR from 59 centres in 11 countries. Patients were divided into 2 groups according to microbiologic etiology: non-SA IE vs SA IE. Results: SA IE was identified in 141 patients out of 573 (24.6%), methicillin-sensitive SA in most cases (115/141, 81.6%). Self-expanding valves were more common than balloon-expandable valves in patients presenting with early SA IE. Major bleeding and sepsis complicating TAVR, neurologic symptoms or systemic embolism at admission, and IE with cardiac device involvement (other than the TAVR prosthesis) were associated with SA IE (P < 0.05 for all). Among patients with IE after TAVR, the likelihood of SA IE increased from 19% in the absence of those risk factors to 84.6% if ≥ 3 risk factors were present. In-hospital (47.8% vs 26.9%; P < 0.001) and 2-year (71.5% vs 49.6%; P < 0.001) mortality rates were higher among patients with SA IE vs non-SA IE. Surgery at the time of index SA IE episode was associated with lower mortality at follow-up compared with medical therapy alone (adjusted hazard ratio 0.46, 95% CI 0.22-0.96; P = 0.038). Conclusions: SA IE represented approximately 25% of IE cases after TAVR and was associated with very high in-hospital and late mortality. The presence of some features determined a higher likelihood of SA IE and could help to orientate early antibiotic regimen selection. Surgery at index SA IE was associated with improved outcomes, and its role should be evaluated in future studies.
Published: 2022

8. Surgical Treatment of Patients With Infective Endocarditis After Transcatheter Aortic Valve Implantation

Author: Mangner, Norman, del Val, David, Abdel-Wahab, Mohamed, Crusius, Lisa, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N., Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C., Testa, Luca, Kim, Won-Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L., Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C., Lisko, John, Gutierrez-Ibanes, Enrique, Serra, Vicenc, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frederic, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B., Mangione, Jose Armando, de Brito, Fabio Sandoli, Dato, Guglielmo Mario Actis, Rosato, Francesco, Ferreira, Maria-Cristina, de Lima, Valter Correia, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Sondergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Herve, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G., Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Cote, Melanie, Holzhey, David, Linke, Axel, Rodes-Cabau, Josep, Mangner, Norman, del Val, David, Abdel-Wahab, Mohamed, Crusius, Lisa, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N., Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C., Testa, Luca, Kim, Won-Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L., Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C., Lisko, John, Gutierrez-Ibanes, Enrique, Serra, Vicenc, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frederic, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B., Mangione, Jose Armando, de Brito, Fabio Sandoli, Dato, Guglielmo Mario Actis, Rosato, Francesco, Ferreira, Maria-Cristina, de Lima, Valter Correia, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Sondergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Herve, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G., Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Cote, Melanie, Holzhey, David, Linke, Axel, and Rodes-Cabau, Josep
Abstract: BACKGROUND The optimal treatment of patients developing infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) is uncertain.OBJECTIVES The goal of this study was to investigate the clinical characteristics and outcomes of patients with TAVI-IE treated with cardiac surgery and antibiotics (IE-CS) compared with patients treated with antibiotics alone (IE-AB).METHODS Crude and inverse probability of treatment weighting analyses were applied for the treatment effect of cardiac surgery vs medical therapy on 1-year all-cause mortality in patients with definite TAVI-IE. The study used data from the Infectious Endocarditis after TAVI International Registry.RESULTS Among 584 patients, 111 patients (19%) were treated with IE-CS and 473 patients (81%) with IE-AB. Compared with IE-AB, IE-CS was not associated with a lower in-hospital mortality (HRunadj: 0.85; 95% CI: 0.58-1.25) and 1-year all-cause mortality (HRunadj: 0.88; 95% CI: 0.64-1.22) in the crude cohort. After adjusting for selection and immortal time bias, IE-CS compared with IE-AB was also not associated with lower mortality rates for in-hospital mortality (HRadj: 0.92; 95% CI: 0.80-1.05) and 1-year all-cause mortality (HRadj: 0.95; 95% CI: 0.84-1.07). Results remained similar when patients with and without TAVI prosthesis involvement were analyzed separately. Predictors for in-hospital and 1-year all-cause mortality included logistic EuroSCORE I, Staphylococcus aureus, acute renal failure, persistent bacteremia, and septic shock.CONCLUSIONS In this registry, the majority of patients with TAVI-IE were treated with antibiotics alone. Cardiac surgery was not associated with an improved all-cause in-hospital or 1-year mortality. The high mortality of patients with TAVI-IE was strongly linked to patients' characteristics, pathogen, and IE-related complications. (C) 2022 by the American College of Cardiology Foundation.
Published: 2022

9. Mitral Valve Infective Endocarditis after Trans-Catheter Aortic Valve Implantation

Author: Panagides, Vassili, del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Scislo, Piotr, Huczek, Zenon, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Kim, Won-Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, de Brito, Fabio Sandoli, Dato, Guglielmo Mario Actis, Rosato, Francesco, Ferreira, Maria-Cristina, de Lima, Valter Correia, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Breton, Hervé Le, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, Rodés-Cabau, Josep, Panagides, Vassili, del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Scislo, Piotr, Huczek, Zenon, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Kim, Won-Keun, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, de Brito, Fabio Sandoli, Dato, Guglielmo Mario Actis, Rosato, Francesco, Ferreira, Maria-Cristina, de Lima, Valter Correia, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Breton, Hervé Le, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, and Rodés-Cabau, Josep
Abstract: Scarce data exist on mitral valve (MV) infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). This multicenter study included a total of 579 patients with a diagnosis of definite IE after TAVI from the IE after TAVI International Registry and aimed to evaluate the incidence, characteristics, management, and outcomes of MV-IE after TAVI. A total of 86 patients (14.9%) had MV-IE. These patients were compared with 284 patients (49.1%) with involvement of the transcatheter heart valve (THV) only. Two factors were found to be associated with MV-IE: the use of self-expanding valves (adjusted odds ratio 2.49, 95% confidence interval [CI] 1.23 to 5.07, p = 0.012), and the presence of an aortic regurgitation ≥2 at discharge (adjusted odds ratio 3.33; 95% CI 1.43 to 7.73, p <0.01). There were no differences in IE timing and causative microorganisms between groups, but surgical management was significantly lower in patients with MV-IE (6.0%, vs 21.6% in patients with THV-IE, p = 0.001). All-cause mortality rates at 2-year follow-up were high and similar between patients with MV-IE (51.4%, 95% CI 39.8 to 64.1) and patients with THV-IE (51.5%, 95% CI 45.4 to 58.0) (log-rank p = 0.295). The factors independently associated with increased mortality risk in patients with MV-IE were the occurrence of heart failure (adjusted p <0.001) and septic shock (adjusted p <0.01) during the index hospitalization. One of 6 IE episodes after TAVI is localized on the MV. The implantation of a self-expanding THV and the presence of an aortic regurgitation ≥2 at discharge were associated with MV-IE. Patients with MV-IE were rarely operated on and had a poor prognosis at 2-year follow-up.
Published: 2022

10. Infective Endocarditis Caused by Staphylococcus aureus After Transcatheter Aortic Valve Replacement

Author: del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Vendramin, Igor, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria-Cristina, Corriea de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, Rodés-Cabau, Josep, del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C, Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Vendramin, Igor, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria-Cristina, Corriea de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, and Rodés-Cabau, Josep
Abstract: Background: Staphylococcus aureus (SA) has been extensively studied as causative microorganism of surgical prosthetic-valve infective endocarditis (IE). However, scarce evidence exists on SA IE after transcatheter aortic valve replacement (TAVR). Methods: Data were obtained from the Infectious Endocarditis After TAVR International Registry, including patients with definite IE after TAVR from 59 centres in 11 countries. Patients were divided into 2 groups according to microbiologic etiology: non-SA IE vs SA IE. Results: SA IE was identified in 141 patients out of 573 (24.6%), methicillin-sensitive SA in most cases (115/141, 81.6%). Self-expanding valves were more common than balloon-expandable valves in patients presenting with early SA IE. Major bleeding and sepsis complicating TAVR, neurologic symptoms or systemic embolism at admission, and IE with cardiac device involvement (other than the TAVR prosthesis) were associated with SA IE (P < 0.05 for all). Among patients with IE after TAVR, the likelihood of SA IE increased from 19% in the absence of those risk factors to 84.6% if ≥ 3 risk factors were present. In-hospital (47.8% vs 26.9%; P < 0.001) and 2-year (71.5% vs 49.6%; P < 0.001) mortality rates were higher among patients with SA IE vs non-SA IE. Surgery at the time of index SA IE episode was associated with lower mortality at follow-up compared with medical therapy alone (adjusted hazard ratio 0.46, 95% CI 0.22-0.96; P = 0.038). Conclusions: SA IE represented approximately 25% of IE cases after TAVR and was associated with very high in-hospital and late mortality. The presence of some features determined a higher likelihood of SA IE and could help to orientate early antibiotic regimen selection. Surgery at index SA IE was associated with improved outcomes, and its role should be evaluated in future studies.
Published: 2022

11. Temporal Trends, Characteristics, and Outcomes of Infective Endocarditis After Transcatheter Aortic Valve Replacement.

Author: UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Département cardiovasculaire, Del Val, David, Abdel-Wahab, Mohamed, Linke, Axel, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Antonio, Herrmann, Howard C, Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, de Brito, Fabio Sandoli, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria-Cristina, Lima, Valter Correa, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S, Boukhris, Marouane, Mangner, Norman, Crusius, Lisa, Holzhey, David, Rodés-Cabau, Josep, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Département cardiovasculaire, Del Val, David, Abdel-Wahab, Mohamed, Linke, Axel, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Antonio, Herrmann, Howard C, Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C, Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Barbanti, Marco, Masson, Jean-Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B, Mangione, Jose Armando, de Brito, Fabio Sandoli, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria-Cristina, Lima, Valter Correa, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G, Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S, Boukhris, Marouane, Mangner, Norman, Crusius, Lisa, Holzhey, David, and Rodés-Cabau, Josep
Abstract: Procedural improvements combined with the contemporary clinical profile of patients undergoing transcatheter aortic valve replacement (TAVR) may have influenced the incidence and outcomes of infective endocarditis (IE) following TAVR. We aimed to determine the temporal trends, characteristics, and outcomes of IE post-TAVR. Observational study including 552 patients presenting definite IE post-TAVR. Patients were divided in 2 groups according to the timing of TAVR (historical cohort [HC]: before 2014; contemporary cohort [CC]: after 2014). Overall incidence rates of IE were similar in both cohorts (CC vs HC: 5.45 vs 6.52 per 1000 person-years; P = .12), but the rate of early IE was lower in the CC (2.29‰ vs 4.89‰, P < .001). Enterococci were the most frequent microorganism. Most patients presented complicated IE ( CC: 67.7%; HC: 69.6%; P = .66), but the rate of surgical treatment remained low (CC: 20.7%; HC: 17.3%; P = .32). The CC exhibited lower rates of in-hospital acute kidney injury (35.1% vs 44.6%; P = .036) and in-hospital (26.6% vs 36.4%; P = .016) and 1-year (37.8% vs 53.5%; P < .001) mortality. Higher logistic EuroScore, Staphylococcus aureus etiology, and complications (stroke, heart failure, and acute renal failure) were associated with in-hospital mortality in multivariable analyses (P < .05 for all). Although overall IE incidence has remained stable, the incidence of early IE has declined in recent years. The microorganism, high rate of complications, and very low rate of surgical treatment remained similar. In-hospital and 1-year mortality rates were high but progressively decreased over time.
Published: 2021

12. Temporal Trends, Characteristics, and Outcomes of Infective Endocarditis After Transcatheter Aortic Valve Replacement

Author: Del Val, David, Abdel-Wahab, Mohamed, Linke, Axel, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Antonio, Herrmann, Howard C., Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C., Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Barbanti, Marco, Masson, Jean Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B., Mangione, Jose Armando, de Brito, Fabio Sandoli, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria Cristina, Lima, Valter Correa, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G., Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Mangner, Norman, Crusius, Lisa, Holzhey, David, Rodés-Cabau, Josep, Del Val, David, Abdel-Wahab, Mohamed, Linke, Axel, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim, Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Antonio, Herrmann, Howard C., Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio, Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C., Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Barbanti, Marco, Masson, Jean Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B., Mangione, Jose Armando, de Brito, Fabio Sandoli, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria Cristina, Lima, Valter Correa, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G., Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Mangner, Norman, Crusius, Lisa, Holzhey, David, and Rodés-Cabau, Josep
Abstract: BACKGROUND: Procedural improvements combined with the contemporary clinical profile of patients undergoing transcatheter aortic valve replacement (TAVR) may have influenced the incidence and outcomes of infective endocarditis (IE) following TAVR. We aimed to determine the temporal trends, characteristics, and outcomes of IE post-TAVR. METHODS: Observational study including 552 patients presenting definite IE post-TAVR. Patients were divided in 2 groups according to the timing of TAVR (historical cohort [HC]: before 2014; contemporary cohort [CC]: after 2014). RESULTS: Overall incidence rates of IE were similar in both cohorts (CC vs HC: 5.45 vs 6.52 per 1000 person-years; P = .12), but the rate of early IE was lower in the CC (2.29‰ vs 4.89‰, P < .001). Enterococci were the most frequent microorganism. Most patients presented complicated IE ( CC: 67.7%; HC: 69.6%; P = .66), but the rate of surgical treatment remained low (CC: 20.7%; HC: 17.3%; P = .32). The CC exhibited lower rates of in-hospital acute kidney injury (35.1% vs 44.6%; P = .036) and in-hospital (26.6% vs 36.4%; P = .016) and 1-year (37.8% vs 53.5%; P < .001) mortality. Higher logistic EuroScore, Staphylococcus aureus etiology, and complications (stroke, heart failure, and acute renal failure) were associated with in-hospital mortality in multivariable analyses (P < .05 for all). CONCLUSIONS: Although overall IE incidence has remained stable, the incidence of early IE has declined in recent years. The microorganism, high rate of complications, and very low rate of surgical treatment remained similar. In-hospital and 1-year mortality rates were high but progressively decreased over time.
Published: 2021

13. Stroke Complicating Infective Endocarditis After Transcatheter Aortic Valve Replacement

Author: del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N., Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C., Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L., Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C., Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B., Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria Cristina, Correia de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G., Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, Rodés-Cabau, Josep, del Val, David, Abdel-Wahab, Mohamed, Mangner, Norman, Durand, Eric, Ihlemann, Nikolaj, Urena, Marina, Pellegrini, Costanza, Giannini, Francesco, Gasior, Tomasz, Wojakowski, Wojtek, Landt, Martin, Auffret, Vincent, Sinning, Jan Malte, Cheema, Asim N., Nombela-Franco, Luis, Chamandi, Chekrallah, Campelo-Parada, Francisco, Munoz-Garcia, Erika, Herrmann, Howard C., Testa, Luca, Won-Keun, Kim, Castillo, Juan Carlos, Alperi, Alberto, Tchetche, Didier, Bartorelli, Antonio L., Kapadia, Samir, Stortecky, Stefan, Amat-Santos, Ignacio, Wijeysundera, Harindra C., Lisko, John, Gutiérrez-Ibanes, Enrique, Serra, Vicenç, Salido, Luisa, Alkhodair, Abdullah, Livi, Ugolino, Chakravarty, Tarun, Lerakis, Stamatios, Vilalta, Victoria, Regueiro, Ander, Romaguera, Rafael, Kappert, Utz, Barbanti, Marco, Masson, Jean Bernard, Maes, Frédéric, Fiorina, Claudia, Miceli, Antonio, Kodali, Susheel, Ribeiro, Henrique B., Mangione, Jose Armando, Sandoli de Brito, Fabio, Actis Dato, Guglielmo Mario, Rosato, Francesco, Ferreira, Maria Cristina, Correia de Lima, Valter, Colafranceschi, Alexandre Siciliano, Abizaid, Alexandre, Marino, Marcos Antonio, Esteves, Vinicius, Andrea, Julio, Godinho, Roger R., Alfonso, Fernando, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Pascual, Isaac, Siddiqui, Saif, Olivares, Paolo, Hernandez-Antolin, Rosana, Webb, John G., Sponga, Sandro, Makkar, Raj, Kini, Annapoorna S., Boukhris, Marouane, Gervais, Philippe, Linke, Axel, Crusius, Lisa, Holzhey, David, and Rodés-Cabau, Josep
Abstract: Background: Stroke is one of the most common and potentially disabling complications of infective endocarditis (IE). However, scarce data exist about stroke complicating IE after transcatheter aortic valve replacement (TAVR). Objectives: The purpose of this study was to determine the incidence, risk factors, clinical characteristics, management, and outcomes of patients with definite IE after TAVR complicated by stroke during index IE hospitalization. Methods: Data from the Infectious Endocarditis after TAVR International Registry (including 569 patients who developed definite IE following TAVR from 59 centers in 11 countries) was analyzed. Patients were divided into two groups according to stroke occurrence during IE admission (stroke [S-IE] vs. no stroke [NS-IE]). Results: A total of 57 (10%) patients had a stroke during IE hospitalization, with no differences in causative microorganism between groups. S-IE patients exhibited higher rates of acute renal failure, systemic embolization, and persistent bacteremia (p < 0.05 for all). Previous stroke before IE, residual aortic regurgitation ≥moderate after TAVR, balloon-expandable valves, IE within 30 days after TAVR, and vegetation size >8 mm were associated with a higher risk of stroke during the index IE hospitalization (p < 0.05 for all). Stroke rate in patients with no risk factors was 3.1% and increased up to 60% in the presence of >3 risk factors. S-IE patients had higher rates of in-hospital mortality (54.4% vs. 28.7%; p < 0.001) and overall mortality at 1 year (66.3% vs. 45.6%; p < 0.001). Surgical treatment was not associated with improved outcomes in S-IE patients (in-hospital mortality: 46.2% in surgical vs. 58.1% in no surgical treatment; p = 0.47). Conclusions: Stroke occurred in 1 of 10 patients with IE post-TAVR. A history of stroke, short time between TAVR and IE, vegetation size, valve prosthesis type, and residual aortic regurgitation determined an increased risk. The occurrence
Published: 2021

14. Insulin resistance and endothelial function are improved after folate and vitamin B12 therapy in patients with metabolic syndrome: relationship between homocysteine levels and hyperinsulinemia

Author: Setola, E, Monti, L, Galluccio, E, Palloshi, A, Fragasso, G, Paroni, R, Magni, F, Sandoli, E, Lucotti, P, Costa, S, Fermo, I, Kienle, M, Origgi, A, Margonato, A, Piatti, P, Monti, LD, Sandoli, EP, Piatti, P., MAGNI, FULVIO, KIENLE, MARZIA DONATELLA, Setola, E, Monti, L, Galluccio, E, Palloshi, A, Fragasso, G, Paroni, R, Magni, F, Sandoli, E, Lucotti, P, Costa, S, Fermo, I, Kienle, M, Origgi, A, Margonato, A, Piatti, P, Monti, LD, Sandoli, EP, Piatti, P., MAGNI, FULVIO, and KIENLE, MARZIA DONATELLA
Abstract: OBJECTIVE: The purpose of this study was (a) to study whether a folate and vitamin B12 treatment, aimed at decreasing homocysteine levels, might ameliorate insulin resistance and endothelial dysfunction in patients with metabolic syndrome according to the National Cholesterol Education Program-Adult Treatment Panel-III criteria and (b) to evaluate whether, under these metabolic conditions, there is a relationship between hyperhomocysteinemia and insulin resistance. DESIGN AND METHODS: A double-blind, parallel, identical placebo-drug, randomized study was performed for 2 months in 50 patients. Patients were randomly allocated to two groups. In group 1, patients were treated with diet plus placebo for 2 months. In group 2, patients were treated with diet plus placebo for 1 month, followed by diet plus folic acid (5 mg/day) plus vitamin B12 (500 microg/day) for another month. RESULTS: In group 2, folate treatment significantly decreased homocysteine levels by 27.8% (12.2+/-1.2 vs 8.8+/-0.7 micromol/l; P<0.01). A significant decrement was observed for insulin levels (19.9+/-1.7 vs 14.8+/-1.6 microU/ml; P<0.01) accompanied by a 27% reduction in the homeostasis model assessment levels. A positive relationship was found between the decrement of homocysteine and insulin levels (r=0.60; P<0.002). In parallel, endothelial dysfunction significantly improved in the treated group, since post-ischemic maximal hyperemic vasodilation increased by 29.8% and cGMP by 13.6% while asymmetrical dimethylarginine levels decreased by 21.7%. On the contrary, in group 1 patients, treated with placebo, no changes were shown in any of the variables. CONCLUSIONS: Folate and vitamin B12 treatment improved insulin resistance and endothelial dysfunction, along with decreasing homocysteine levels, in patients with metabolic syndrome, suggesting that folic acid has several beneficial effects on cardiovascular disease risk factors.
Published: 2004

15. Myocardial insulin resistance associated with chronic hypertriglyceridemia and increased FFA levels in Type 2 diabetic patients

Author: Monti, L, Landoni, C, Setola, E, Galluccio, E, Lucotti, P, Sandoli, E, Origgi, A, Lucignani, G, Piatti, P, Fazio, F, Monti, LD, Sandoli, EP, LANDONI, CLAUDIO, FAZIO, FERRUCCIO, Monti, L, Landoni, C, Setola, E, Galluccio, E, Lucotti, P, Sandoli, E, Origgi, A, Lucignani, G, Piatti, P, Fazio, F, Monti, LD, Sandoli, EP, LANDONI, CLAUDIO, and FAZIO, FERRUCCIO
Abstract: We evaluated the influence of chronic hypertriglyceridemia and endothelial dysfunction on myocardial glucose uptake (MGU) in Type 2 diabetic patients without coronary heart disease. Patients were divided into two groups according to fasting triglyceride (TG) levels: 5.4 ± 1.1 and 1.5 ± 0.3 mmol/l for high- and normal-TG groups, respectively. Five subjects were assigned to the high-TG group and 11 to the normal-TG group. Age, gender, body mass index, systolic and diastolic blood pressure, glucose, insulin, HbA1c, cholesterol, and HDL cholesterol were similar in the two groups, whereas free fatty acid (FFA) levels were higher in the high-TG group basally and at the end of the clamp. Furthermore, five healthy subjects were subjected to the same protocol and used as the control group. MGU was assessed by using 18F-labeled 2-fluoro-2-deoxy-D-glucose under hyperglycemic- hyperinsulinemic conditions. Basal endothelin-1 and nitric oxide levels were significantly higher in the high-TG group than in the normal-TG and control groups, and cGMP and maximal postischemic vasodilation were significantly decreased in the high-TG group compared with the normal-TG and control groups. However, significant alterations were found in the same parameters in the normal-TG group compared with the control group. By the end of the hyperglycemic clamp, in the high-TG group, MGU was ∼40 and 65% of that in the normal-TG and control groups. MGU negatively correlated with TG, FFA, and endothelin-1, whereas a positive correlation was found with cGMP and maximal postischemic vasodilation. In conclusion, increased TG and FFA levels are risks, in addition to Type 2 diabetes mellitus, for myocardial insulin resistance, endothelial dysfunction, and alteration of nitric oxide/cGMP levels.
Published: 2004

16. Comportamento sismico, modellazione e progettazione di edifici in legno a pannelli X-lam

Author: Sandoli, Antonio and Sandoli, Antonio
Abstract: Le costruzioni massicce a pannelli X-lam rappresentano, almeno in Italia, la tecnologia costruttiva più largamente diffusa per la realizzazione di edifici in legno, questo perché grazie alle prerogative di leggerezza, sostenibilità e buon comportamento termico consentono di realizzare costruzioni ad elevate performance. Ma, questo rapido sviluppo degli edifici in legno non è stato, di pari passo, accompagnato da un significativo aggiornamento del quadro normativo in materia di progettazione sismica, né a livello nazionale, né a livello europeo. Pertanto, la necessità di disporre di regole di progettazione comunemente condivise dalla comunità scientifica ha dato spunto al presente lavoro di ricerca finalizzato ad approfondire il comportamento sismico degli edifici in legno e a fornire regole progettuali in linea con il moderno concetto del capacity design. Nel presente lavoro di tesi, dopo aver messo a punto un criterio di modellazione del comportamento meccanico del “materiale” e delle connessioni, è stato possibile definire modelli “sofisticati” di pareti a pannelli X-lam finalizzati allo svolgimento di analisi numeriche utili alla comprensione del loro comportamento sismico. La possibilità di disporre di tali modelli ha consentito, quindi, di investigare il ruolo delle connessioni sul comportamento pareti definendone, di volta in volta, la loro capacità sismica ed il fattore di struttura. Inoltre, la mancanza di regole di progettazione in linea con l’approccio del capacity design ha spinto ad investigare il ruolo della progettazione, svolta secondo dettagliate regole di gerarchia delle resistenze, sulla capacità sismica delle pareti. E’ stato analizzato il comportamento di pareti lignee le cui connessioni meccaniche sono state progettate secondo differenti approcci di gerarchia delle resistenze, ipotizzando alternativamente che il comportamento dissipativo sia affidato alle piattine metalliche oppure all’interazione chiodi-legno. Le analisi svolte hanno consentito
Published: 2016

17. Response to letters regarding article, 'Infective endocarditis after transcatheter aortic valve implantation : results from a large multicenter registry'.

Author: Dumont, Éric, Messika-Zeitoun, David, Nombela-Franco, Luis, Eltchaninoff, Hélène, Rodés-Cabau, Josep, Kapadia, Samir R., Amat Santos, Ignacio J., Lerakis, Stamatios A., Urena Alcazar, Marina, Cheema, Asim, Pibarot, Philippe, Gutiérrez-Ibañes, Enrique, Ribeiro, Henrique B., Muñoz, Antonio, Pan, Manuel, Webb, John G. (John Graydon), Herrmann, Howard C., Kodali, Susheel, Tamburino, Corrado, Jilaihawi, Hasan, Masson, Jean-Bernard, Brito, Fabio Sandoli de, Ferreira, Maria Cristina, Lima, Valter Correa, Mangione, José Armando, Iung, Bernard, Vahanian, Alec, Durand, Éric, Tuzcu, Murat, Hayek, Salim, Angulo-Llanos, Rocio, Gómez-Doblas, Juan José, Castillo Dominguez, Juan Carlos, Dvir, Danny, Leon, Martin B., Garcia, Eulogio, Cobiella Carnicer, Javier, Barbanti, Marco, Makkar, Rajendra, López Diez, Javier, San Román, Alberto, Dumont, Éric, Messika-Zeitoun, David, Nombela-Franco, Luis, Eltchaninoff, Hélène, Rodés-Cabau, Josep, Kapadia, Samir R., Amat Santos, Ignacio J., Lerakis, Stamatios A., Urena Alcazar, Marina, Cheema, Asim, Pibarot, Philippe, Gutiérrez-Ibañes, Enrique, Ribeiro, Henrique B., Muñoz, Antonio, Pan, Manuel, Webb, John G. (John Graydon), Herrmann, Howard C., Kodali, Susheel, Tamburino, Corrado, Jilaihawi, Hasan, Masson, Jean-Bernard, Brito, Fabio Sandoli de, Ferreira, Maria Cristina, Lima, Valter Correa, Mangione, José Armando, Iung, Bernard, Vahanian, Alec, Durand, Éric, Tuzcu, Murat, Hayek, Salim, Angulo-Llanos, Rocio, Gómez-Doblas, Juan José, Castillo Dominguez, Juan Carlos, Dvir, Danny, Leon, Martin B., Garcia, Eulogio, Cobiella Carnicer, Javier, Barbanti, Marco, Makkar, Rajendra, López Diez, Javier, and San Román, Alberto
Published: 2016

18. Infective endocarditis after transcatheter aortic valve implantation : results from a large multicenter registry

Author: Dumont, Éric, Messika-Zeitoun, David, Nombela-Franco, Luis, Eltchaninoff, Hélène, Rodés-Cabau, Josep, Kapadia, Samir R., Amat Santos, Ignacio J., Lerakis, Stamatios A., Urena Alcazar, Marina, Cheema, Asim, Pibarot, Philippe, Gutiérrez-Ibañes, Enrique, Ribeiro, Henrique B., Muñoz, Antonio, Pan, Manuel, Webb, John G. (John Graydon), Herrmann, Howard C., Kodali, Susheel, Tamburino, Corrado, Jilaihawi, Hasan, Masson, Jean-Bernard, Brito, Fabio Sandoli de, Ferreira, Maria Cristina, Lima, Valter Correa, Mangione, José Armando, Iung, Bernard, Vahanian, Alec, Durand, Éric, Tuzcu, Murat, Hayek, Salim, Angulo-Llanos, Rocio, Gómez-Doblas, Juan José, Castillo Dominguez, Juan Carlos, Dvir, Danny, Leon, Martin B., Garcia, Eulogio, Cobiella Carnicer, Javier, Vilacosta, Isidre, Barbanti, Marco, Makkar, Rajendra, López Diez, Javier, San Román, Alberto, Dumont, Éric, Messika-Zeitoun, David, Nombela-Franco, Luis, Eltchaninoff, Hélène, Rodés-Cabau, Josep, Kapadia, Samir R., Amat Santos, Ignacio J., Lerakis, Stamatios A., Urena Alcazar, Marina, Cheema, Asim, Pibarot, Philippe, Gutiérrez-Ibañes, Enrique, Ribeiro, Henrique B., Muñoz, Antonio, Pan, Manuel, Webb, John G. (John Graydon), Herrmann, Howard C., Kodali, Susheel, Tamburino, Corrado, Jilaihawi, Hasan, Masson, Jean-Bernard, Brito, Fabio Sandoli de, Ferreira, Maria Cristina, Lima, Valter Correa, Mangione, José Armando, Iung, Bernard, Vahanian, Alec, Durand, Éric, Tuzcu, Murat, Hayek, Salim, Angulo-Llanos, Rocio, Gómez-Doblas, Juan José, Castillo Dominguez, Juan Carlos, Dvir, Danny, Leon, Martin B., Garcia, Eulogio, Cobiella Carnicer, Javier, Vilacosta, Isidre, Barbanti, Marco, Makkar, Rajendra, López Diez, Javier, and San Román, Alberto
Abstract: Background— We aimed to determine the incidence, predictors, clinical characteristics, management, and outcomes of infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). Methods and Results— This multicenter registry included 53 patients (mean age, 79±8 years; men, 57%) who suffered IE after TAVI of 7944 patients after a mean follow-up of 1.1±1.2 years (incidence, 0.67%, 0.50% within the first year after TAVI). Mean time from TAVI was 6 months (interquartile range, 1–14 months). Orotracheal intubation (hazard ratio, 3.87; 95% confidence interval, 1.55–9.64; P=0.004) and the self-expandable CoreValve system (hazard ratio, 3.12; 95% confidence interval, 1.37–7.14; P=0.007) were associated with IE (multivariate analysis including 3067 patients with individual data). The most frequent causal microorganisms were coagulase-negative staphylococci (24%), followed by Staphylococcus aureus (21%) and enterococci (21%). Vegetations were present in 77% of patients (transcatheter valve leaflets, 39%; stent frame, 17%; mitral valve, 21%). At least 1 complication of IE occurred in 87% of patients (heart failure in 68%). However, only 11% of patients underwent valve intervention (valve explantation and valve-in-valve procedure in 4 and 2 patients, respectively). The mortality rate in hospital was 47.2% and increased to 66% at the 1-year follow-up. IE complications such as heart failure (P=0.037) and septic shock (P=0.002) were associated with increased in-hospital mortality. Conclusions— The incidence of IE at 1 year after TAVI was 0.50%, and the risk increased with the use of orotracheal intubation and a self-expandable valve system. Staphylococci and enterococci were the most common agents. Although most patients presented at least 1 complication of IE, valve intervention was performed in a minority of patients, and nearly half of the patients died during the hospitalization period.
Published: 2016

19. Predictors and impact of myocardial injury after transcatheter aortic valve replacement : a multicenter registry.

Author: Campelo-Parada, Francisco, Dumont, Éric, Muñoz, Antonio, Abdul-Jawad Altisent, Omar, Lemos, Pedro A., Côté, Mélanie, Nombela-Franco, Luis, Serra, Vicenç, Rodés-Cabau, Josep, Brito, Fabio Sandoli de, Amat Santos, Ignacio J., Abizaid, Alexandre, Del Trigo, Maria, Sarmento-Leite, Rogério, Urena Alcazar, Marina, Pibarot, Philippe, Cheema, Asim, Puri, Rishi, Ruel, Marc, Ribeiro, Henrique B., Nietlispach, Fabian, Maisano, Francesco, Moris, Cesar, Valle, Raquel del, Jiménez-Quevedo, Pilar, Alonso-Briales, Juan H., Gutiérrez, Hipólito, García del Blanco, Bruno, Perin, Marco Antonio, Siqueira, Dimytri, Bernardi, Guilherme, Campelo-Parada, Francisco, Dumont, Éric, Muñoz, Antonio, Abdul-Jawad Altisent, Omar, Lemos, Pedro A., Côté, Mélanie, Nombela-Franco, Luis, Serra, Vicenç, Rodés-Cabau, Josep, Brito, Fabio Sandoli de, Amat Santos, Ignacio J., Abizaid, Alexandre, Del Trigo, Maria, Sarmento-Leite, Rogério, Urena Alcazar, Marina, Pibarot, Philippe, Cheema, Asim, Puri, Rishi, Ruel, Marc, Ribeiro, Henrique B., Nietlispach, Fabian, Maisano, Francesco, Moris, Cesar, Valle, Raquel del, Jiménez-Quevedo, Pilar, Alonso-Briales, Juan H., Gutiérrez, Hipólito, García del Blanco, Bruno, Perin, Marco Antonio, Siqueira, Dimytri, and Bernardi, Guilherme
Abstract: BACKGROUND : Cardiac biomarker release signifying myocardial injury post-transcatheter aortic valve replacement (TAVR) is common, yet its clinical impact within a large TAVR cohort receiving differing types of valve and procedural approaches is unknown. OBJECTIVES : This study sought to determine the incidence, clinical impact, and factors associated with cardiac biomarker elevation post TAVR. METHODS : This multicenter study included 1,131 consecutive patients undergoing TAVR with balloon-expandable (58%) or self-expandable (42%) valves. Transfemoral and transapical (TA) approaches were selected in 73.1% and 20.3% of patients, respectively. Creatine kinase-myocardial band (CK-MB) measurements were obtained at baseline and at several time points within the initial 72 h post TAVR. Echocardiography was performed at baseline and at 6- to 12-month follow-up. RESULTS : Overall, 66% of the TAVR population demonstrated some degree of myocardial injury as determined by a rise in CK-MB levels (peak value: 1.6-fold [interquartile range (IQR): 0.9 to 2.8-fold]). A TA approach and major procedural complications were independently associated with higher peak of CK-MB levels (p < 0.01 for all), which translated into impaired systolic left ventricular function at 6 to 12 months post TAVR (p < 0.01). A greater rise in CK-MB levels independently associated with an increased 30-day, late (median of 21 [IQR: 8 to 36] months) overall and cardiovascular mortality (p < 0.001 for all). Any increase in CK-MB levels was associated with poorer clinical outcomes, and there was a stepwise rise in late mortality according to the various degrees of CK-MB increase after TAVR (p < 0.001). CONCLUSIONS : Some degree of myocardial injury was detected in two-thirds of patients post TAVR, especially in those undergoing TA-TAVR or presenting with major procedural complications. A greater rise in CK-MB levels associated with greater acute and late mortality, imparting a negative impact on left ventricula
Published: 2016

20. Comportamento sismico, modellazione e progettazione di edifici in legno a pannelli X-lam

Author: Sandoli, Antonio and Sandoli, Antonio
Abstract: Le costruzioni massicce a pannelli X-lam rappresentano, almeno in Italia, la tecnologia costruttiva più largamente diffusa per la realizzazione di edifici in legno, questo perché grazie alle prerogative di leggerezza, sostenibilità e buon comportamento termico consentono di realizzare costruzioni ad elevate performance. Ma, questo rapido sviluppo degli edifici in legno non è stato, di pari passo, accompagnato da un significativo aggiornamento del quadro normativo in materia di progettazione sismica, né a livello nazionale, né a livello europeo. Pertanto, la necessità di disporre di regole di progettazione comunemente condivise dalla comunità scientifica ha dato spunto al presente lavoro di ricerca finalizzato ad approfondire il comportamento sismico degli edifici in legno e a fornire regole progettuali in linea con il moderno concetto del capacity design. Nel presente lavoro di tesi, dopo aver messo a punto un criterio di modellazione del comportamento meccanico del “materiale” e delle connessioni, è stato possibile definire modelli “sofisticati” di pareti a pannelli X-lam finalizzati allo svolgimento di analisi numeriche utili alla comprensione del loro comportamento sismico. La possibilità di disporre di tali modelli ha consentito, quindi, di investigare il ruolo delle connessioni sul comportamento pareti definendone, di volta in volta, la loro capacità sismica ed il fattore di struttura. Inoltre, la mancanza di regole di progettazione in linea con l’approccio del capacity design ha spinto ad investigare il ruolo della progettazione, svolta secondo dettagliate regole di gerarchia delle resistenze, sulla capacità sismica delle pareti. E’ stato analizzato il comportamento di pareti lignee le cui connessioni meccaniche sono state progettate secondo differenti approcci di gerarchia delle resistenze, ipotizzando alternativamente che il comportamento dissipativo sia affidato alle piattine metalliche oppure all’interazione chiodi-legno. Le analisi svolte hanno consentito
Published: 2016

21. Response to letters regarding article, 'Infective endocarditis after transcatheter aortic valve implantation : results from a large multicenter registry'.

Author: Amat Santos, Ignacio J., Messika-Zeitoun, David, Eltchaninoff, Hélène, Kapadia, Samir R., Lerakis, Stamatios A., Cheema, Asim, Gutiérrez-Ibañes, Enrique, Muñoz, Antonio, Pan, Manuel, Webb, John G. (John Graydon), Herrmann, Howard C., Kodali, Susheel, Nombela-Franco, Luis, Tamburino, Corrado, Jilaihawi, Hasan, Masson, Jean-Bernard, Brito, Fabio Sandoli de, Ferreira, Maria Cristina, Lima, Valter Correa, Mangione, José Armando, Iung, Bernard, Vahanian, Alec, Durand, Éric, Tuzcu, Murat, Hayek, Salim, Angulo-Llanos, Rocio, Gómez-Doblas, Juan José, Castillo Dominguez, Juan Carlos, Dvir, Danny, Leon, Martin B., Garcia, Eulogio, Cobiella Carnicer, Javier, Barbanti, Marco, Makkar, Rajendra, Barbosa Ribeiro, Henrique, Urena Alcazar, Marina, Dumont, Éric, Pibarot, Philippe, López Diez, Javier, San Román, Alberto, Rodés-Cabau, Josep, Amat Santos, Ignacio J., Messika-Zeitoun, David, Eltchaninoff, Hélène, Kapadia, Samir R., Lerakis, Stamatios A., Cheema, Asim, Gutiérrez-Ibañes, Enrique, Muñoz, Antonio, Pan, Manuel, Webb, John G. (John Graydon), Herrmann, Howard C., Kodali, Susheel, Nombela-Franco, Luis, Tamburino, Corrado, Jilaihawi, Hasan, Masson, Jean-Bernard, Brito, Fabio Sandoli de, Ferreira, Maria Cristina, Lima, Valter Correa, Mangione, José Armando, Iung, Bernard, Vahanian, Alec, Durand, Éric, Tuzcu, Murat, Hayek, Salim, Angulo-Llanos, Rocio, Gómez-Doblas, Juan José, Castillo Dominguez, Juan Carlos, Dvir, Danny, Leon, Martin B., Garcia, Eulogio, Cobiella Carnicer, Javier, Barbanti, Marco, Makkar, Rajendra, Barbosa Ribeiro, Henrique, Urena Alcazar, Marina, Dumont, Éric, Pibarot, Philippe, López Diez, Javier, San Román, Alberto, and Rodés-Cabau, Josep
Published: 2015

22. Predictors and impact of myocardial injury after transcatheter aortic valve replacement : a multicenter registry.

Author: Barbosa Ribeiro, Henrique, Nombela-Franco, Luis, Muñoz, Antonio, Lemos, Pedro A., Amat Santos, Ignacio J., Serra, Vicenç, Brito, Fabio Sandoli de, Abizaid, Alexandre, Sarmento-Leite, Rogério, Puri, Rishi, Cheema, Asim, Ruel, Marc, Nietlispach, Fabian, Maisano, Francesco, Moris, Cesar, Valle, Raquel del, Urena Alcazar, Marina, Abdul-Jawad Altisent, Omar, Del Trigo, Maria, Campelo-Parada, Francisco, Jiménez-Quevedo, Pilar, Alonso-Briales, Juan H., Gutiérrez, Hipólito, García del Blanco, Bruno, Perin, Marco Antonio, Siqueira, Dimytri, Bernardi, Guilherme, Dumont, Éric, Côté, Mélanie, Pibarot, Philippe, Rodés-Cabau, Josep, Barbosa Ribeiro, Henrique, Nombela-Franco, Luis, Muñoz, Antonio, Lemos, Pedro A., Amat Santos, Ignacio J., Serra, Vicenç, Brito, Fabio Sandoli de, Abizaid, Alexandre, Sarmento-Leite, Rogério, Puri, Rishi, Cheema, Asim, Ruel, Marc, Nietlispach, Fabian, Maisano, Francesco, Moris, Cesar, Valle, Raquel del, Urena Alcazar, Marina, Abdul-Jawad Altisent, Omar, Del Trigo, Maria, Campelo-Parada, Francisco, Jiménez-Quevedo, Pilar, Alonso-Briales, Juan H., Gutiérrez, Hipólito, García del Blanco, Bruno, Perin, Marco Antonio, Siqueira, Dimytri, Bernardi, Guilherme, Dumont, Éric, Côté, Mélanie, Pibarot, Philippe, and Rodés-Cabau, Josep
Abstract: BACKGROUND : Cardiac biomarker release signifying myocardial injury post-transcatheter aortic valve replacement (TAVR) is common, yet its clinical impact within a large TAVR cohort receiving differing types of valve and procedural approaches is unknown. OBJECTIVES : This study sought to determine the incidence, clinical impact, and factors associated with cardiac biomarker elevation post TAVR. METHODS : This multicenter study included 1,131 consecutive patients undergoing TAVR with balloon-expandable (58%) or self-expandable (42%) valves. Transfemoral and transapical (TA) approaches were selected in 73.1% and 20.3% of patients, respectively. Creatine kinase-myocardial band (CK-MB) measurements were obtained at baseline and at several time points within the initial 72 h post TAVR. Echocardiography was performed at baseline and at 6- to 12-month follow-up. RESULTS : Overall, 66% of the TAVR population demonstrated some degree of myocardial injury as determined by a rise in CK-MB levels (peak value: 1.6-fold [interquartile range (IQR): 0.9 to 2.8-fold]). A TA approach and major procedural complications were independently associated with higher peak of CK-MB levels (p < 0.01 for all), which translated into impaired systolic left ventricular function at 6 to 12 months post TAVR (p < 0.01). A greater rise in CK-MB levels independently associated with an increased 30-day, late (median of 21 [IQR: 8 to 36] months) overall and cardiovascular mortality (p < 0.001 for all). Any increase in CK-MB levels was associated with poorer clinical outcomes, and there was a stepwise rise in late mortality according to the various degrees of CK-MB increase after TAVR (p < 0.001). CONCLUSIONS : Some degree of myocardial injury was detected in two-thirds of patients post TAVR, especially in those undergoing TA-TAVR or presenting with major procedural complications. A greater rise in CK-MB levels associated with greater acute and late mortality, imparting a negative impact on left ventricula
Published: 2015

23. Infective endocarditis after transcatheter aortic valve implantation : results from a large multicenter registry

Author: Amat Santos, Ignacio J., Messika-Zeitoun, David, Eltchaninoff, Hélène, Kapadia, Samir R., Lerakis, Stamatios A., Cheema, Asim, Gutiérrez-Ibañes, Enrique, Muñoz, Antonio, Pan, Manuel, Webb, John G. (John Graydon), Herrmann, Howard C., Kodali, Susheel, Nombela-Franco, Luis, Tamburino, Corrado, Jilaihawi, Hasan, Masson, Jean-Bernard, Brito, Fabio Sandoli de, Ferreira, Maria Cristina, Lima, Valter Correa, Mangione, José Armando, Iung, Bernard, Vahanian, Alec, Durand, Éric, Tuzcu, Murat, Hayek, Salim, Angulo-Llanos, Rocio, Gómez-Doblas, Juan José, Castillo Dominguez, Juan Carlos, Dvir, Danny, Leon, Martin B., Garcia, Eulogio, Cobiella Carnicer, Javier, Vilacosta, Isidre, Barbanti, Marco, Makkar, Rajendra, Barbosa Ribeiro, Henrique, Urena Alcazar, Marina, Dumont, Éric, Pibarot, Philippe, López Diez, Javier, San Román, Alberto, Rodés-Cabau, Josep, Amat Santos, Ignacio J., Messika-Zeitoun, David, Eltchaninoff, Hélène, Kapadia, Samir R., Lerakis, Stamatios A., Cheema, Asim, Gutiérrez-Ibañes, Enrique, Muñoz, Antonio, Pan, Manuel, Webb, John G. (John Graydon), Herrmann, Howard C., Kodali, Susheel, Nombela-Franco, Luis, Tamburino, Corrado, Jilaihawi, Hasan, Masson, Jean-Bernard, Brito, Fabio Sandoli de, Ferreira, Maria Cristina, Lima, Valter Correa, Mangione, José Armando, Iung, Bernard, Vahanian, Alec, Durand, Éric, Tuzcu, Murat, Hayek, Salim, Angulo-Llanos, Rocio, Gómez-Doblas, Juan José, Castillo Dominguez, Juan Carlos, Dvir, Danny, Leon, Martin B., Garcia, Eulogio, Cobiella Carnicer, Javier, Vilacosta, Isidre, Barbanti, Marco, Makkar, Rajendra, Barbosa Ribeiro, Henrique, Urena Alcazar, Marina, Dumont, Éric, Pibarot, Philippe, López Diez, Javier, San Román, Alberto, and Rodés-Cabau, Josep
Abstract: Background—We aimed to determine the incidence, predictors, clinical characteristics, management, and outcomes of infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). Methods and Results—This multicenter registry included 53 patients (mean age, 79±8 years; men, 57%) who suffered IE after TAVI of 7944 patients after a mean follow-up of 1.1±1.2 years (incidence, 0.67%, 0.50% within the first year after TAVI). Mean time from TAVI was 6 months (interquartile range, 1–14 months). Orotracheal intubation (hazard ratio, 3.87; 95% confidence interval, 1.55–9.64; P=0.004) and the self-expandable CoreValve system (hazard ratio, 3.12; 95% confidence interval, 1.37–7.14; P=0.007) were associated with IE (multivariate analysis including 3067 patients with individual data). The most frequent causal microorganisms were coagulase-negative staphylococci (24%), followed by Staphylococcus aureus (21%) and enterococci (21%). Vegetations were present in 77% of patients (transcatheter valve leaflets, 39%; stent frame, 17%; mitral valve, 21%). At least 1 complication of IE occurred in 87% of patients (heart failure in 68%). However, only 11% of patients underwent valve intervention (valve explantation and valve-in-valve procedure in 4 and 2 patients, respectively). The mortality rate in hospital was 47.2% and increased to 66% at the 1-year follow-up. IE complications such as heart failure (P=0.037) and septic shock (P=0.002) were associated with increased in-hospital mortality. Conclusions—The incidence of IE at 1 year after TAVI was 0.50%, and the risk increased with the use of orotracheal intubation and a self-expandable valve system. Staphylococci and enterococci were the most common agents. Although most patients presented at least 1 complication of IE, valve intervention was performed in a minority of patients, and nearly half of the patients died during the hospitalization period.
Published: 2015

24. The impact of calcium volume and distribution in aortic root injury related to balloon-expandable transcatheter aortic valve replacement

Author: Hansson, Nicolaj C., Norgaard, Bjarne L., Barbanti, Marco, Nielsen, Niels Erik, Yang, Tae-Hyun, Tamburino, Corrado, Dvir, Danny, Jilaihawi, Hasan, Blanke, Philip, Makkar, Raj R., Latib, Azeem, Colombo, Antonio, Tarantini, Giuseppe, Raju, Rekha, Wood, David, Andersen, Henning R., Ribeiro, Henrique B., Kapadia, Samir, Min, James, Feuchtner, Gudrun, Gurvitch, Ronen, Alqoofi, Faisal, Pelletier, Marc, Paolo Ussia, Gian, Napodano, Massimo, de Brito, Fabio Sandoli Jr., Kodali, Susheel, Pache, Gregor, Canovas, Sergio J., Berger, Adam, Murphy, Darra, Svensson, Lars G., Rodes-Cabau, Josep, Leon, Martin B., Webb, John G., Leipsic, Jonathon, Hansson, Nicolaj C., Norgaard, Bjarne L., Barbanti, Marco, Nielsen, Niels Erik, Yang, Tae-Hyun, Tamburino, Corrado, Dvir, Danny, Jilaihawi, Hasan, Blanke, Philip, Makkar, Raj R., Latib, Azeem, Colombo, Antonio, Tarantini, Giuseppe, Raju, Rekha, Wood, David, Andersen, Henning R., Ribeiro, Henrique B., Kapadia, Samir, Min, James, Feuchtner, Gudrun, Gurvitch, Ronen, Alqoofi, Faisal, Pelletier, Marc, Paolo Ussia, Gian, Napodano, Massimo, de Brito, Fabio Sandoli Jr., Kodali, Susheel, Pache, Gregor, Canovas, Sergio J., Berger, Adam, Murphy, Darra, Svensson, Lars G., Rodes-Cabau, Josep, Leon, Martin B., Webb, John G., and Leipsic, Jonathon
Abstract: Background: A detailed assessment of calcium within the aortic root may provide important additional information regarding the risk of aortic root injury during transcatheter heart valve replacement (TAVR). Objective: We sought to delineate the effect of calcium volume and distribution on aortic root injury during TAVR. Methods: Thirty-three patients experiencing aortic root injury during TAVR with a balloon-expandable valve were compared with a control group of 153 consecutive TAVR patients without aortic root injury (as assessed by post-TAVR multidetector CT). Using commercial software to analyze contrast-enhanced pre-TAVR CT scans, caltium volume was determined in 3 regions: (1) the overall left ventricular outflow tract (LVOT), extending 10 mm down from the aortic annulus plane; (2) the upper LVOT, extending 2 mm down from the annulus plane; and (3) the aortic valve region. Results: Calcium volumes in the upper LVOT (median, 29 vs 0 mm(3); P less than .0001) and overall LVOT (median, 74 vs 3 mm(3); P = .0001) were higher in patients who experienced aortic root injury compared with the control group. Calcium in the aortic valve region did not differ between groups. Upper LVOT calcium volume was more predictive of aortic root injury than overall LVOT calcium volume (area under receiver operating curve [AUG]; 0.78; 95% confidence interval, 0.69-0.86 vs AUC, 0.71; 95% confidence interval, 0.62-0.82; P = .010). Upper LVOT calcium below the noncoronary cusp was significantly more predictive of aortic root injury compared to calcium underneath the right coronary cusp or the left coronary cusp (AUC, 0.81 vs 0.68 vs 0.64). Prosthesis oversizing greater than20% (likelihood ratio test, P = .028) and redilatation (likelihood ratio test, P = .015) improved prediction of aortic root injury by upper LVOT calcium volume. Conclusion: Calcification of the LVOT, especially in the upper LVOT, located below the noncoronary cusp and extending from the annular region, is predictive of, Funding Agencies|Edwards Lifesciences; Danish Heart Foundation
Published: 2015
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25. Prompt dipole radiation in fusion reactions

Author: De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, Sandoli, Mario, De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, and Sandoli, Mario
Published: 2008

26. Prompt dipole radiation in fusion reactions

Author: De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, Sandoli, Mario, De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, and Sandoli, Mario
Published: 2008

27. The heavy-ion magnetic spectrometer PRISMA

Author: La Commara, Marco, Sandoli, Mario, La Commara, Marco, and Sandoli, Mario
Published: 2007

28. Light radioactive nuclear beams at LNL

Author: De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, Sandoli, Mario, De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, and Sandoli, Mario
Published: 2007

29. Prompt dipole gamma-ray emission in fusion heavy-ion reactions: dependence on incident energy

Author: Inglima, Giovanni, De Rosa, Antonio, La Commara, Marco, Sandoli, Mario, Inglima, Giovanni, De Rosa, Antonio, La Commara, Marco, and Sandoli, Mario
Published: 2007

30. Elastic scattering for the system 11Be+209Bi at Coulomb barrier energies

Author: De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, Sandoli, Mario, Vardaci, Emanuele, De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, Sandoli, Mario, and Vardaci, Emanuele
Published: 2007

31. Elastic scattering for the system 11Be+209Bi at Coulomb barrier energies

Author: De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, Sandoli, Mario, Vardaci, Emanuele, De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, Sandoli, Mario, and Vardaci, Emanuele
Published: 2007

32. Prompt dipole gamma-ray emission in fusion heavy-ion reactions: dependence on incident energy

Author: Inglima, Giovanni, De Rosa, Antonio, La Commara, Marco, Sandoli, Mario, Inglima, Giovanni, De Rosa, Antonio, La Commara, Marco, and Sandoli, Mario
Published: 2007

33. The heavy-ion magnetic spectrometer PRISMA

Author: La Commara, Marco, Sandoli, Mario, La Commara, Marco, and Sandoli, Mario
Published: 2007

34. Light radioactive nuclear beams at LNL

Author: De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, Sandoli, Mario, De Rosa, Antonio, Inglima, Giovanni, La Commara, Marco, and Sandoli, Mario
Published: 2007

35. Scattering of 11Be halo nucleus from 209Bi at the Coulomb barrier

Author: Inglima, Giovanni, La Commara, Marco, Sandoli, Mario, Inglima, Giovanni, La Commara, Marco, and Sandoli, Mario
Published: 2006

36. Scattering of 11Be halo nucleus from 209Bi at the Coulomb barrier

Author: Inglima, Giovanni, La Commara, Marco, Sandoli, Mario, Inglima, Giovanni, La Commara, Marco, and Sandoli, Mario
Published: 2006

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