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1. Invasive Assessment of Right Ventricular to Pulmonary Artery Coupling Improves 1-year Mortality Prediction After Transcatheter Aortic Valve Replacement and Anticipates the Persistence of Extra-Aortic Valve Cardiac Damage

Author

Lachmann, Mark, Hesse, Amelie, Trenkwalder, Teresa, Xhepa, Erion, Rheude, Tobias, von Scheidt, Moritz, Covarrubias, Héctor Alfonso Alvarez, Rippen, Elena, Hramiak, Oksana, Pellegrini, Costanza, Schuster, Tibor, Yuasa, Shinsuke, Schunkert, Heribert, Kastrati, Adnan, Kupatt, Christian, Laugwitz, Karl-Ludwig, and Joner, Michael

Published
2024
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2. 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, 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, Jr., 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

Published
2022
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3. Feasibility of Coronary Access in Patients With Acute Coronary Syndrome and Previous TAVR

Author

Kim, Won-Keun, Pellegrini, Costanza, Ludwig, Sebastian, Möllmann, Helge, Leuschner, Florian, Makkar, Raj, Leick, Jürgen, Amat-Santos, Ignacio J., Dörr, Oliver, Breitbart, Philipp, Jimenez Diaz, Victor A., Dabrowski, Maciej, Rudolph, Tanja, Avanzas, Pablo, Kaur, Jatinderjit, Toggweiler, Stefan, Kerber, Sebastian, Ranosch, Patrick, Regazzoli, Damiano, Frank, Derk, Landes, Uri, Webb, John, Barbanti, Marco, Purita, Paola, Pilgrim, Thomas, Liska, Branislav, Tabata, Noriaki, Rheude, Tobias, Seiffert, Moritz, Eckel, Clemens, Allali, Abdelhakim, Valvo, Roberto, Yoon, Sung-Han, Werner, Nikos, Nef, Holger, Choi, Yeong-Hoon, Hamm, Christian W., and Sinning, Jan-Malte

Published
2021
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4. 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 Jr, 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

Published
2021
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6. Valve-in-Valve Implantation Using the ACURATE Neo in Degenerated Aortic Bioprostheses: An International Multicenter Analysis

Author

Holzamer, Andreas, Kim, Won-Keun, Rück, Andreas, Sathananthan, Janarthanan, Keller, Lukas, Cosma, Joseph, Bauer, Timm, Nef, Holger, Amat-Santos, Ignacio J., Brinkert, Miriam, Husser, Oliver, Pellegrini, Costanza, Schofer, Joachim, Nerla, Roberto, Montorfano, Matteo, Giannini, Francesco, Stella, Pieter, Kuwata, Shingo, Hilker, Michael, Castriota, Fausto, Ussia, Gian Paolo, Webb, John G., Nietlispach, Fabian, and Toggweiler, Stefan

Published
2019
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9. The Early neo2 Registry: Transcatheter Aortic Valve Implantation With ACURATE neo2 in a European Population

Author

Rück, Andreas, primary, Kim, Won‐Keun, additional, Abdel‐Wahab, Mohamed, additional, Thiele, Holger, additional, Rudolph, Tanja K., additional, Wolf, Alexander, additional, Wambach, Jan Martin, additional, De Backer, Ole, additional, Sondergaard, Lars, additional, Hengstenberg, Christian, additional, Laine, Mika, additional, Miyashita, Hirokazu, additional, Bjursten, Henrik, additional, Götberg, Matthias, additional, Pellegrini, Costanza, additional, Toggweiler, Stefan, additional, Wykrzykowska, Joanna J., additional, Soliman, Osama, additional, Saleh, Nawzad, additional, and Meduri, Christopher U., additional

Published
2023
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11. Standardized Minimalistic Transfemoral Transcatheter Aortic Valve Replacement (TAVR) Using the SAPIEN 3 Device: Stepwise Description, Feasibility, and Safety from a Large Consecutive Single-Center Single-Operator Cohort

Author

Frangieh, Antonio H., Ott, Ilka, Michel, Jonathan, Shivaraju, Anupama, Joner, Michael, Mayr, N. Patrick, Hengstenberg, Christian, Husser, Oliver, Pellegrini, Costanza, Schunkert, Heribert, Kastrati, Adnan, and Kasel, Albert Markus

Published
2017
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12. Infective Endocarditis Following Transcatheter Aortic Valve Replacement: Comparison of Balloon- Versus Self-Expandable Valves

Author

Regueiro, Ander, Linke, Axel, Latib, Azeem, Ihlemann, Nikolaj, Urena, Marina, Walther, Thomas, Husser, Oliver, Herrmann, Howard C., Nombela-Franco, Luis, Cheema, Asim, Le Breton, Hervé, Stortecky, Stefan, Kapadia, Samir, Bartorelli, Antonio L., Sinning, Jan Malte, Amat-Santos, Ignacio, Munoz-Garcia, Antonio J., Lerakis, Stamatios, Gutiérrez-Ibanes, Enrique, Abdel-Wahab, Mohamed, Tchetche, Didier, Testa, Luca, Eltchaninoff, Helene, Livi, Ugolino, Castillo, Juan Carlos, Jilaihawi, Hasan, Webb, John G., Barbanti, Marco, Kodali, Susheel, de Brito, Fabio S., Jr, Ribeiro, Henrique B., Miceli, Antonio, Fiorina, Claudia, Actis Dato, Guglielmo Mario, Rosato, Francesco, Serra, Vicenç, Masson, Jean-Bernard, Wijeysundera, Harindra C., Mangione, Jose A., Ferreira, Maria-Cristina, Lima, Valter C., Carvalho, Luis A., Abizaid, Alexandre, Marino, Marcos A., Esteves, Vinicius, Andrea, Julio C.M., Messika-Zeitoun, David, Himbert, Dominique, Kim, Won-Keun, Pellegrini, Costanza, Auffret, Vincent, Nietlispach, Fabian, Pilgrim, Thomas, Durand, Eric, Lisko, John, Makkar, Raj R., Lemos, Pedro, Leon, Martin B., Puri, Rishi, San Roman, Alberto, Vahanian, Alec, Søndergaard, Lars, Mangner, Norman, and Rodés-Cabau, Josep

Published
2019
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13. Correlación fluoroscópica y tomográfica para medir el anillo aórtico en implante percutáneo de válvula aórtica: regla de cúspide coronaria derecha

Author

Álvarez Covarrubias, Héctor A., Kasel, Albert Markus, Michel, Jonathan M., Cassese, Salvatore, Kufner, Sebastian, Duesmann, Charlotte, Pellegrini, Costanza, Rheude, Tobias, Mayr, Nicola Patrick, Schunkert, Heribert, Kastrati, Adnan, Xhepa, Erion, Borrayo Sánchez, Gabriela, Joner, Michael, Álvarez Covarrubias, Héctor A., Kasel, Albert Markus, Michel, Jonathan M., Cassese, Salvatore, Kufner, Sebastian, Duesmann, Charlotte, Pellegrini, Costanza, Rheude, Tobias, Mayr, Nicola Patrick, Schunkert, Heribert, Kastrati, Adnan, Xhepa, Erion, Borrayo Sánchez, Gabriela, and Joner, Michael

Abstract

Introduction and objectives: Coronary computed tomography angiography (CCTA) has become the gold standard to measure the size of the aortic annulus and better select the size of transcatheter heart valves (THV) in patients undergoing transcatheter aortic valve implantation (TAVI). However, in selected cases, CCTA may not be feasible. Angiographic aortic annulus (AAA) measurements during TAVI may be an alternative and should be evaluated for precision regarding the proper selection of THV sizes. We sought to investigate the correlation between AAA and CCTA measurements for the proper selection of balloon-expandable valve (BEV) sizes in patients undergoing TAVI. Methods: Patients undergoing TAVI with BEV and high-quality CCTA were included. AAA measurements were obtained in the standard 3-cusp view after aortic root aortography. Angiographic distance between non- and left coronary cusps were compared to CCTA annulus measurements. Endpoints were diagnostic tests and correlations between angiographic and CCTA measurements, and the composite endpoint of the VARC-3-defined efficacy (technical success, correct position, and intended performance), and safety profile (multiple valves, valve embolization, pacemaker implantation, and more than moderate valvular regurgitation). Results: Regarding the Sapien family of THV, aortography-based distance measurements showed a correlation of 0.528 (P < .01), 0.451 (P < .01), and 0.579 (P < .01) for 23 mm, 26 mm, and 29 mm valves with CCTA-based distance measurements. No difference was seen regarding the VARC-3-defined efficacy (94.2% vs 96.0%; P = .60) and safety profile (90.9% vs 91.9%; P = .84) among cases showing discordant and concordant pairs of measurements. Conclusions: AAA measurement showed a moderate diagnostic test and Spearman’s correlation coefficient compared to CCTA-based annulus assessment for perioperative THV size selection. This strategy could potentially enable TAVI in patients in whom access to preoperative CCTA i, Introducción y objetivos: La angiografía por tomografía computarizada (angio-TC) es el estándar para medir el anillo aórtico en pacientes tratados mediante implante percutáneo de válvula aórtica (TAVI), aunque en algunos casos podría no ser factible. Debería evaluarse la precisión de las medición del anillo aórtico angiográfica (AAA) durante el TAVI como alternativa para elegir el tamaño correcto de la válvula cardiaca percutánea. Por ello, investigamos la correlación entre las mediciones angiográficas y por angio-TC para elegir el tamaño adecuado de la válvula en pacientes que reciben un TAVI. Métodos: Se incluyeron pacientes de TAVI con prótesis de balón expandible y angio-TC de alta calidad. Las mediciones del AAA se obtuvieron de la angiografía de la raíz aórtica en proyección de 3 cúspides. Se comparó la distancia angiográfica entre la cúspide izquierda y no coronariana con las mediciones de angio-TC. Se evaluaron la prueba diagnóstica y la correlación entre las medidas angiográficas y de angio-TC, así como la eficacia (éxito técnico, posición correcta y desempeño intencionado) y la seguridad (múltiples válvulas, embolización, implante de marcapasos e insuficiencia valvular moderada o mayor) definida por VARC-3. Resultados: Para válvulas con balón expandible de 23 mm, la distancia en la aortografía tuvo una correlación de 0,528 (p < 0,01) comparada con las mediciones de angio-TC; para las de 26 mm, la correlación fue de 0,451 (< 0,01), y para las de 29 mm fue de 0,579 (< 0,01). No hubo diferencia en cuanto a eficacia (94,2 frente a 96,0%; p = 0,60) y seguridad (90,9 frente a 91,9%; p = 0,84) entre casos con medidas concordantes y discordantes. Conclusiones: Las mediciones del AAA mostraron un moderado valor de prueba diagnóstica y de correlación Spearman en comparación con la angio-TC para elegir el tamaño de la válvula cardiaca percutánea. Esta estrategia podría permitir un TAVI en situaciones en que la angio-TC no esté disponible.

Published
2023

14. Incidence, Clinical Characteristics, and Impact of Absent Echocardiographic Signs in Patients with Infective Endocarditis after Transcatheter Aortic Valve Implantation

Author

Mangner, Norman, Panagides, Vassili, 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, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Gervais, Philippe, Côté, Mélanie, Thiele, Holger, Holzhey, David, Linke, Axel, Rodés-Cabau, Josep, Mangner, Norman, Panagides, Vassili, 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, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Gervais, Philippe, Côté, Mélanie, Thiele, Holger, Holzhey, David, Linke, Axel, and Rodés-Cabau, Josep

Abstract

Background Echocardiography is the primary imaging modality for diagnosis of infective endocarditis (IE) in prosthetic valve endocarditis (PVE) including IE after transcatheter aortic valve implantation (TAVI). This study aimed to evaluate the characteristics and clinical outcomes of patients with absent compared with evident echocardiographic signs of TAVI-IE. Methods Patients with definite TAVI-IE derived from the Infectious Endocarditis after TAVI International Registry were investigated comparing those with absent and evident echocardiographic signs of IE defined as vegetation, abscess, pseudo-aneurysm, intracardiac fistula, or valvular perforation or aneurysm. Results Among 578 patients, 87 (15.1%) and 491 (84.9%) had absent (IE-neg) and evident (IE-pos) echocardiographic signs of IE, respectively. IE-neg were more often treated via a transfemoral access with a self-expanding device and had higher rates of peri-interventional complications (eg, stroke, major vascular complications) during the TAVI procedure (P < .05 for all). IE-neg had higher rates of IE caused by Staphylococcus aureus (33.7% vs 23.2%; P = .038) and enterococci (37.2% vs 23.8%; P = .009) but lower rates of coagulase-negative staphylococci (4.7% vs 20.0%, P = .001). IE-neg was associated with the same dismal prognosis for in-hospital mortality in a multivariate binary regression analysis (odds ratio: 1.51; 95% confidence interval [CI]: .55–4.12) as well as a for 1-year mortality in Cox regression analysis (hazard ratio: 1.10; 95% CI: .67–1.80). Conclusions Even with negative echocardiographic imaging, patients who have undergone TAVI and presenting with positive blood cultures and symptoms of infection are a high-risk patient group having a reasonable suspicion of IE and the need for an early treatment initiation., Background. Echocardiography is the primary imaging modality for diagnosis of infective endocarditis (IE) in prosthetic valve endocarditis (PVE) including IE after transcatheter aortic valve implantation (TAVI). This study aimed to evaluate the characteristics and clinical outcomes of patients with absent compared with evident echocardiographic signs of TAVI-IE. Methods. Patients with definite TAVI-IE derived from the Infectious Endocarditis after TAVI International Registry were investigated comparing those with absent and evident echocardiographic signs of IE defined as vegetation, abscess, pseudo-aneurysm, intracardiac fistula, or valvular perforation or aneurysm. Results. Among 578 patients, 87 (15.1%) and 491 (84.9%) had absent (IE-neg) and evident (IE-pos) echocardiographic signs of IE, respectively. IE-neg were more often treated via a transfemoral access with a self-expanding device and had higher rates of peri-interventional complications (eg, stroke, major vascular complications) during the TAVI procedure (P < .05 for all). IE-neg had higher rates of IE caused by Staphylococcus aureus (33.7% vs 23.2%; P = .038) and enterococci (37.2% vs 23.8%; P = .009) but lower rates of coagulase-negative staphylococci (4.7% vs 20.0%, P = .001). IE-neg was associated with the same dismal prognosis for in-hospital mortality in a multivariate binary regression analysis (odds ratio: 1.51; 95% confidence interval [CI]: .55–4.12) as well as a for 1-year mortality in Cox regression analysis (hazard ratio: 1.10; 95% CI: .67–1.80). Conclusions. Even with negative echocardiographic imaging, patients who have undergone TAVI and presenting with positive blood cultures and symptoms of infection are a high-risk patient group having a reasonable suspicion of IE and the need for an early treatment initiation.

Published
2023

17. The impact of extra-valvular cardiac damage on mid-term clinical outcome following transcatheter aortic valve replacement in patients with severe aortic stenosis

Author

Pellegrini, Costanza, primary, Duesmann, Charlotte, additional, Rheude, Tobias, additional, Berg, Amelie, additional, Alvarez-Covarrubias, Hector A., additional, Trenkwalder, Teresa, additional, Mayr, N. Patrick, additional, Schürmann, Friederike, additional, Nicol, Philipp, additional, Xhepa, Erion, additional, and Joner, Michael, additional

Published
2022
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18. Artificial intelligence-enabled phenotyping of patients with severe aortic stenosis: on the recovery of extra-aortic valve cardiac damage after transcatheter aortic valve replacement

Author

Lachmann, Mark, primary, Rippen, Elena, additional, Schuster, Tibor, additional, Xhepa, Erion, additional, von Scheidt, Moritz, additional, Trenkwalder, Teresa, additional, Pellegrini, Costanza, additional, Rheude, Tobias, additional, Hesse, Amelie, additional, Stundl, Anja, additional, Harmsen, Gerhard, additional, Yuasa, Shinsuke, additional, Schunkert, Heribert, additional, Kastrati, Adnan, additional, Laugwitz, Karl-Ludwig, additional, Joner, Michael, additional, and Kupatt, Christian, additional

Published
2022
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19. Efficacy and Safety of Ticagrelor Versus Prasugrel in Women and Men with Acute Coronary Syndrome: A Pre-specified, Sex-Specific Analysis of the ISAR-REACT 5 Trial

Author

Gewalt, Senta, primary, Lahu, Shqipdona, additional, Ndrepepa, Gjin, additional, Pellegrini, Costanza, additional, Bernlochner, Isabell, additional, Neumann, Franz-Josef, additional, Menichelli, Maurizio, additional, Morath, Tanja, additional, Witzenbichler, Bernhard, additional, Wöhrle, Jochen, additional, Hoppe, Katharina, additional, Richardt, Gert, additional, Laugwitz, Karl-Ludwig, additional, Schunkert, Heribert, additional, Kastrati, Adnan, additional, Schüpke, Stefanie, additional, and Mayer, Katharina, additional

Published
2022
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20. 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

21. 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

22. 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

23. Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement

Author

Panagides, Vassili, 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, Eltchaninoff, Helene, Sondergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, le Breton, Hervé, Servoz, Clement, Gervais, Philippe, del Val, David, Linke, Axel, Crusius, Lisa, Thiele, Holger, Holzhey, David, Rodés-Cabau, Josep, Panagides, Vassili, 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, Eltchaninoff, Helene, Sondergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, le Breton, Hervé, Servoz, Clement, Gervais, Philippe, del Val, David, Linke, Axel, Crusius, Lisa, Thiele, Holger, Holzhey, David, and Rodés-Cabau, Josep

Abstract

Background: Outcomes after transcatheter aortic valve replacement (TAVR) and infectious diseases may vary according to sex. Methods: This multicentre study aimed to determine the sex differences in clinical characteristics, management, and outcomes of infective endocarditis (IE) after TAVR. A total of 579 patients (217 women, 37.5%) who had the diagnosis of definite IE following TAVR were included retrospectively from the Infectious Endocarditis After TAVR International Registry. Results: Women were older (80 ± 8 vs 78 ± 8 years; P = 0.001) and exhibited a lower comorbidity burden. Clinical characteristics and microbiological profiles were similar between men and women, but culture-negative IE was more frequent in women (9.9% vs 4.3%; P = 0.009). A high proportion of patients had a clinical indication for surgery (54.4% in both groups; P = 0.99), but a surgical intervention was performed in a minority of patients (women 15.2%, men 20.3%; P = 0.13). The mortality rate at index IE hospitalisation was similar in both groups (women 35.4%, men 31.7%; P = 0.37), but women exhibited a higher mortality rate at 2-year follow-up (63% vs 52.1%; P = 0.021). Female sex remained an independent risk factor for cumulative mortality in the multivariable analysis (adjusted HR 1.28, 95% CI 1.02-1.62; P = 0.035). After adjustment for in-hospital events, surgery was not associated with better outcomes in women. Conclusions: There were no significant sex-related differences in the clinical characteristics and management of IE after TAVR. However, female sex was associated with increased 2-year mortality risk.

Published
2022

24. Very early infective endocarditis after transcatheter aortic valve replacement

Author

Panagides, Vassili, 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, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Gervais, Philippe, del Val, David, Linke, Axel, Crusius, Lisa, Thiele, Holger, Holzhey, David, Rodés-Cabau, Josep, Panagides, Vassili, 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, Eltchaninoff, Helene, Søndergaard, Lars, Himbert, Dominique, Husser, Oliver, Latib, Azeem, Le Breton, Hervé, Servoz, Clement, Gervais, Philippe, del Val, David, Linke, Axel, Crusius, Lisa, Thiele, Holger, Holzhey, David, and Rodés-Cabau, Josep

Abstract

Background: Scarce data exist about early infective endocarditis (IE) after trans-catheter aortic valve replacement (TAVR). Objective: The objective was to evaluate the characteristics, management, and outcomes of very early (VE) IE (≤ 30 days) after TAVR. Methods: This multicenter study included a total of 579 patients from the Infectious Endocarditis after TAVR International Registry who had the diagnosis of definite IE following TAVR. Results: Ninety-one patients (15.7%) had VE-IE. Factors associated with VE-IE (vs. delayed IE (D-IE)) were female gender (p = 0.047), the use of self-expanding valves (p < 0.001), stroke (p = 0.019), and sepsis (p < 0.001) after TAVR. Staphylococcus aureus was the main pathogen among VE-IE patients (35.2% vs. 22.7% in the D-IE group, p = 0.012), and 31.2% of Staphylococcus aureus infections in the VE-IE group were methicillin-resistant (vs. 14.3% in the D-IE group, p = 0.001). The second-most common germ was enterococci (34.1% vs. 24.4% in D-IE cases, p = 0.05). VE-IE was associated with very high in-hospital (44%) and 1-year (54%) mortality rates. Acute renal failure following TAVR (p = 0.001) and the presence of a non-enterococci pathogen (p < 0.001) were associated with an increased risk of death. Conclusion: A significant proportion of IE episodes following TAVR occurs within a few weeks following the procedure and are associated with dismal outcomes. Some baseline and TAVR procedural factors were associated with VE-IE, and Staphylococcus aureus and enterococci were the main causative pathogens. These results may help to select the more appropriate antibiotic prophylaxis in TAVR procedures and guide the initial antibiotic therapy in those cases with a clinical suspicion of IE. Graphical abstract: Very early infective endocarditis after trans-catheter aortic valve replacement. VE-IE indicates very early infective endocarditis (≤30 days post TAVR). D-IE indicates delayed infective endocarditis. [Figure not available: s

Published
2022

25. 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

26. 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

27. 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

28. Harnessing feature extraction capacities from a pre-trained convolutional neural network (VGG-16) for the unsupervised distinction of aortic outflow velocity profiles in patients with severe aortic stenosis

Author

Lachmann, Mark, primary, Rippen, Elena, additional, Rueckert, Daniel, additional, Schuster, Tibor, additional, Xhepa, Erion, additional, von Scheidt, Moritz, additional, Pellegrini, Costanza, additional, Trenkwalder, Teresa, additional, Rheude, Tobias, additional, Stundl, Anja, additional, Thalmann, Ruth, additional, Harmsen, Gerhard, additional, Yuasa, Shinsuke, additional, Schunkert, Heribert, additional, Kastrati, Adnan, additional, Joner, Michael, additional, Kupatt, Christian, additional, and Laugwitz, Karl Ludwig, additional

Published
2022
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32. TCT-230 One-Year Results After Transcatheter Aortic Valve Replacement With Balloon-Expandable Valves: Comparison of SAPIEN 3 Ultra and SAPIEN 3

Author

Rheude, Tobias, primary, Kornhuber, Katharina, additional, Pellegrini, Costanza, additional, Freißmuth, Markus, additional, Syryca, Finn, additional, Mayr, Patrick, additional, Covarrubias, Hector Alvarez, additional, Kasel, Markus, additional, Joner, Michael, additional, and Xhepa, Erion, additional

Published
2021
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34. Subphenotyping of Patients With Aortic Stenosis by Unsupervised Agglomerative Clustering of Echocardiographic and Hemodynamic Data

Author

Lachmann, Mark, primary, Rippen, Elena, additional, Schuster, Tibor, additional, Xhepa, Erion, additional, von Scheidt, Moritz, additional, Pellegrini, Costanza, additional, Trenkwalder, Teresa, additional, Rheude, Tobias, additional, Stundl, Anja, additional, Thalmann, Ruth, additional, Harmsen, Gerhard, additional, Yuasa, Shinsuke, additional, Schunkert, Heribert, additional, Kastrati, Adnan, additional, Laugwitz, Karl-Ludwig, additional, Kupatt, Christian, additional, and Joner, Michael, additional

Published
2021
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36. 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

37. 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

38. Influence of marital status in patients undergoing transcatheter aortic valve implantation

Author

Pellegrini, Costanza, Rheude, Tobias, Mahr, Lukas, Trenkwalder, Teresa, Mayr, N. Patrick, Michel, Jonathan, Schunkert, Heribert, Kasel, A. Markus, Joner, Michael, Hengstenberg, Christian, Kastrati, Adnan, Husser, Oliver, Kessler, Thorsten, University of Zurich, and Pellegrini, Costanza

Subjects
2740 Pulmonary and Respiratory Medicine, 10209 Clinic for Cardiology, Original Article, 610 Medicine & health
Abstract

BACKGROUND: Marital status has been described to affect outcome in cardiovascular diseases, however its impact on patients undergoing transcatheter aortic valve implantation (TAVI) is unknown. We therefore aimed to assess the impact of marital status in patients undergoing TAVI. METHODS: Between 2011 and 2015, 779 patients undergoing transfemoral TAVI with known marital status were included in the analysis. The primary endpoint of the study was the composite of cardiac death and readmission for congestive heart failure (CHF) at one year. RESULTS: Mean age was 80.7±5.9 years, 47.8% were female and median logistic EuroScore was 12.7% (8.13–19.39%). Forty-three point three percent of patients were not married. Compared to married patients, unmarried patients were older (82.4±5.5 vs. 79.5±5.8 years; P

Published
2019

39. Comparison of latest generation supra-annular and intra-annular self-expanding transcatheter heart valves

Author

Pellegrini, Costanza; https://orcid.org/0000-0001-5143-8203, Rheude, Tobias; https://orcid.org/0000-0002-3426-6080, Michel, Jonathan, Alvarez-Covarrubias, Hector A, Wünsch, Sarah, Mayr, N Patrick; https://orcid.org/0000-0002-3549-3007, Xhepa, Erion, Kastrati, Adnan, Schunkert, Heribert, Joner, Michael, Kasel, Markus, Pellegrini, Costanza; https://orcid.org/0000-0001-5143-8203, Rheude, Tobias; https://orcid.org/0000-0002-3426-6080, Michel, Jonathan, Alvarez-Covarrubias, Hector A, Wünsch, Sarah, Mayr, N Patrick; https://orcid.org/0000-0002-3549-3007, Xhepa, Erion, Kastrati, Adnan, Schunkert, Heribert, Joner, Michael, and Kasel, Markus

Abstract

Background: This study compares two latest-generation self-expanding transcatheter heart valves (THV), the supra-annular ACURATE neo (Boston Scientific) and the intra-annular Centera THV (Edwards Lifesciences). Methods: In this single center observational cohort trial 317 patients treated with the ACURATE neo and 78 patients treated with the Centera TVH were included. The main endpoints were device success and the early safety endpoint at 30 days. Results: Besides higher incidence of diabetes mellitus and higher body mass index in patients treated with the ACURATE neo THV, there were no baseline differences between the groups. Device success was similar in both groups (neo: 91.8% vs. Centera: 93.6%; P=0.598), with numerically higher rates of moderate to severe paravalvular leakage in the ACURATE neo group (4.7% vs. 1.3%; P=0.214). At 30 days all-cause mortality rates were low in both groups (0.3% vs. 0%; P=0.620) and no difference occurred in the early safety at 30 days (19.3% vs. 16.7%; P=0.599). However, all-cause stroke rates were significantly higher in patients treated with the Centera THV (6.4 vs. 1.6%; P=0.015). Conclusions: The ACURATE neo and the Centera THV show low mortality rates as well as comparable, favorable hemodynamics. The finding of higher stroke rates at 30 days with the repositionable Centera SE-THV needs further assessment.

Published
2020

40. Prognostic value of the H 2 FPEF score in patients undergoing transcatheter aortic valve implantation

Author

Ludwig, Sebastian, primary, Pellegrini, Costanza, additional, Gossling, Alina, additional, Rheude, Tobias, additional, Voigtländer, Lisa, additional, Bhadra, Oliver D., additional, Linder, Matthias, additional, Kalbacher, Daniel, additional, Koell, Benedikt, additional, Waldschmidt, Lara, additional, Schirmer, Johannes, additional, Seiffert, Moritz, additional, Reichenspurner, Hermann, additional, Blankenberg, Stefan, additional, Westermann, Dirk, additional, Conradi, Lenard, additional, Joner, Michael, additional, and Schofer, Niklas, additional

Published
2020
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42. Long-Term Outcomes After Infective Endocarditis After Transcatheter Aortic Valve Replacement

Author

del Val, David, primary, Linke, Axel, additional, Abdel-Wahab, Mohamed, additional, Latib, Azeem, additional, Ihlemann, Nikolaj, additional, Urena, Marina, additional, Won-Keun, Kim, additional, Husser, Oliver, additional, Herrmann, Howard C., additional, Nombela-Franco, Luis, additional, Cheema, Asim N., additional, Le Breton, Hervé, additional, Stortecky, Stefan, additional, Bartorelli, Antonio L., additional, Sinning, Jan Malte, additional, Amat-Santos, Ignacio, additional, Munoz-Garcia, Antonio, additional, Lerakis, Stamatios, additional, Gutiérrez-Ibanez, Enrique, additional, Landt, Martin, additional, Tchetche, Didier, additional, Testa, Luca, additional, Eltchaninoff, Helene, additional, Livi, Ugolino, additional, Castillo, Juan Carlos, additional, Chakravarty, Tarun, additional, Webb, John G., additional, Barbanti, Marco, additional, Kodali, Susheel, additional, de Brito, Fabio S., additional, Ribeiro, Henrique Barbosa, additional, Miceli, Antonio, additional, Fiorina, Claudia, additional, Dato, Guglielmo Mario Actis, additional, Rosato, Francesco, additional, Serra, Vicenç, additional, Masson, Jean-Bernard, additional, Wijeysundera, Harindra C., additional, Mangione, Jose A., additional, Ferreira, Maria-Cristina, additional, Lima, Valter Correa, additional, Colafranceschi, Alexandre Siciliano, additional, Abizaid, Alexandre, additional, Marino, Marcos Antonio, additional, Esteves, Vinicius, additional, Andrea, Julio C.M., additional, Himbert, Dominique, additional, Pellegrini, Costanza, additional, Auffret, Vincent, additional, Olivares, Paolo, additional, Nietlispach, Fabian, additional, Pilgrim, Thomas, additional, Durand, Eric, additional, Lisko, John, additional, Makkar, Raj, additional, Alkhodair, Abdullah, additional, Søndergaard, Lars, additional, Mangner, Norman, additional, Crusius, Lisa, additional, Holzhey, David, additional, Regueiro, Ander, additional, and Rodés-Cabau, Josep, additional

Published
2020
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43. Valor pronóstico diferencial de la galectina-3 según los valores de antígeno carbohidrato 125 para el implante percutáneo de válvula aórtica

Author

Rheude, Tobias, primary, Pellegrini, Costanza, additional, Núñez, Julio, additional, Joner, Michael, additional, Trenkwalder, Teresa, additional, Mayr, N. Patrick, additional, Holdenrieder, Stefan, additional, Bodi, Vicent, additional, Koenig, Wolfgang, additional, Kasel, Albert M., additional, Schunkert, Heribert, additional, Kastrati, Adnan, additional, Hengstenberg, Christian, additional, and Husser, Oliver, additional

Published
2019
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44. Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)

Author

Kim, Won-Keun, Schaefer, Ulrich, Tchetche, Didier, Nef, Holger, Arnold, Martin, Avanzas, Pablo, Rudolph, Tanja, Scholtz, Smita, Barbanti, Marco, Kempfert, Joerg, Mangieri, Antonio, Lauten, Alexander, Frerker, Christian, Yoon, Sung-Han, Holzamer, Andreas, Praz, Fabien, De Backer, Ole, Toggweiler, Stefan, Blumenstein, Johannes, Purita, Paola, Tarantini, Giuseppe, Thilo, Christian, Wolf, Alexander, Husser, Oliver, Pellegrini, Costanza, Burgdorf, Christof, Antolin, Rosa Ana Hernandez, Diaz, Victor A. Jimenez, Liebetrau, Christoph, Schofer, Niklas, Moellmann, Helge, Eggebrecht, Holger, Sondergaard, Lars, Walther, Thomas, Pilgrim, Thomas, Hilker, Michael, Makkar, Raj, Unbehaun, Axel, Boergermann, Jochen, Moris, Cesar, Achenbach, Stephan, Doerr, Oliver, Brochado, Bruno, Conradi, Lenard, Hamm, Christian W., Kim, Won-Keun, Schaefer, Ulrich, Tchetche, Didier, Nef, Holger, Arnold, Martin, Avanzas, Pablo, Rudolph, Tanja, Scholtz, Smita, Barbanti, Marco, Kempfert, Joerg, Mangieri, Antonio, Lauten, Alexander, Frerker, Christian, Yoon, Sung-Han, Holzamer, Andreas, Praz, Fabien, De Backer, Ole, Toggweiler, Stefan, Blumenstein, Johannes, Purita, Paola, Tarantini, Giuseppe, Thilo, Christian, Wolf, Alexander, Husser, Oliver, Pellegrini, Costanza, Burgdorf, Christof, Antolin, Rosa Ana Hernandez, Diaz, Victor A. Jimenez, Liebetrau, Christoph, Schofer, Niklas, Moellmann, Helge, Eggebrecht, Holger, Sondergaard, Lars, Walther, Thomas, Pilgrim, Thomas, Hilker, Michael, Makkar, Raj, Unbehaun, Axel, Boergermann, Jochen, Moris, Cesar, Achenbach, Stephan, Doerr, Oliver, Brochado, Bruno, Conradi, Lenard, and Hamm, Christian W.

Abstract

Aims Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort. Methods and results We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92%) TAVI cases (age 80.8 +/- 7.3 years; 53.8% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0%), multiple valve implantations (83.2%), and conversion to surgery (19.0%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6% vs. 4.9%; P < 0.001) and after 1 year (30.5% vs. 16.6%; P < 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6% vs. 2.8%; P < 0.001), but not at 1 year (4.6% vs. 1.9%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective. Conclusion Transcatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality.

Published
2019

45. Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration:The TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)

Author

Kim, Won Keun, Schäfer, Ulrich, Tchetche, Didier, Nef, Holger, Arnold, Martin, Avanzas, Pablo, Rudolph, Tanja, Scholtz, Smita, Barbanti, Marco, Kempfert, Jörg, Mangieri, Antonio, Lauten, Alexander, Frerker, Christian, Yoon, Sung Han, Holzamer, Andreas, Praz, Fabien, De Backer, Ole, Toggweiler, Stefan, Blumenstein, Johannes, Purita, Paola, Tarantini, Giuseppe, Thilo, Christian, Wolf, Alexander, Husser, Oliver, Pellegrini, Costanza, Burgdorf, Christof, Antolin, Rosa Ana Hernandez, Díaz, Victor A.Jiménez, Liebetrau, Christoph, Schofer, Niklas, Möllmann, Helge, Eggebrecht, Holger, Sondergaard, Lars, Walther, Thomas, Pilgrim, Thomas, Hilker, Michael, Makkar, Raj, Unbehaun, Axel, Börgermann, Jochen, Moris, Cesar, Achenbach, Stephan, Dörr, Oliver, Brochado, Bruno, Conradi, Lenard, Hamm, Christian W., Kim, Won Keun, Schäfer, Ulrich, Tchetche, Didier, Nef, Holger, Arnold, Martin, Avanzas, Pablo, Rudolph, Tanja, Scholtz, Smita, Barbanti, Marco, Kempfert, Jörg, Mangieri, Antonio, Lauten, Alexander, Frerker, Christian, Yoon, Sung Han, Holzamer, Andreas, Praz, Fabien, De Backer, Ole, Toggweiler, Stefan, Blumenstein, Johannes, Purita, Paola, Tarantini, Giuseppe, Thilo, Christian, Wolf, Alexander, Husser, Oliver, Pellegrini, Costanza, Burgdorf, Christof, Antolin, Rosa Ana Hernandez, Díaz, Victor A.Jiménez, Liebetrau, Christoph, Schofer, Niklas, Möllmann, Helge, Eggebrecht, Holger, Sondergaard, Lars, Walther, Thomas, Pilgrim, Thomas, Hilker, Michael, Makkar, Raj, Unbehaun, Axel, Börgermann, Jochen, Moris, Cesar, Achenbach, Stephan, Dörr, Oliver, Brochado, Bruno, Conradi, Lenard, and Hamm, Christian W.

Abstract

Aims: Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort. Methods and results: We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92%) TAVI cases (age 80.8 ± 7.3 years; 53.8% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0%), multiple valve implantations (83.2%), and conversion to surgery (19.0%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6% vs. 4.9%; P < 0.001) and after 1 year (30.5% vs. 16.6%; P < 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6% vs. 2.8%; P < 0.001), but not at 1 year (4.6% vs. 1.9%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective. Conclusion: Transcatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality.

Published
2019

46. Infective Endocarditis Following Transcatheter Aortic Valve Replacement:Comparison of Balloon-Versus Self-Expandable Valves

Author

Regueiro, Ander, Linke, Axel, Latib, Azeem, Ihlemann, Nikolaj, Urena, Marina, Walther, Thomas, Husser, Oliver, Herrmann, Howard C., Nombela-Franco, Luis, Cheema, Asim, Le Breton, Hervé, Stortecky, Stefan, Kapadia, Samir, Bartorelli, Antonio L., Sinning, Jan Malte, Amat-Santos, Ignacio, Munoz-Garcia, Antonio J., Lerakis, Stamatios, Gutiérrez-Ibanes, Enrique, Abdel-Wahab, Mohamed, Tchetche, Didier, Testa, Luca, Eltchaninoff, Helene, Livi, Ugolino, Castillo, Juan Carlos, Jilaihawi, Hasan, Webb, John G., Barbanti, Marco, Kodali, Susheel, De Brito, Fabio S., Ribeiro, Henrique B., Miceli, Antonio, Fiorina, Claudia, Actis Dato, Guglielmo Mario, Rosato, Francesco, Serra, Vicenç, Masson, Jean Bernard, Wijeysundera, Harindra C., Mangione, Jose A., Ferreira, Maria Cristina, Lima, Valter C., Carvalho, Luis A., Abizaid, Alexandre, Marino, Marcos A., Esteves, Vinicius, Andrea, Julio C.M., Messika-Zeitoun, David, Himbert, Dominique, Kim, Won Keun, Pellegrini, Costanza, Auffret, Vincent, Nietlispach, Fabian, Pilgrim, Thomas, Durand, Eric, Lisko, John, Makkar, Raj R., Lemos, Pedro, Leon, Martin B., Puri, Rishi, San Roman, Alberto, Vahanian, Alec, Søndergaard, Lars, Mangner, Norman, Rodés-Cabau, Josep, Regueiro, Ander, Linke, Axel, Latib, Azeem, Ihlemann, Nikolaj, Urena, Marina, Walther, Thomas, Husser, Oliver, Herrmann, Howard C., Nombela-Franco, Luis, Cheema, Asim, Le Breton, Hervé, Stortecky, Stefan, Kapadia, Samir, Bartorelli, Antonio L., Sinning, Jan Malte, Amat-Santos, Ignacio, Munoz-Garcia, Antonio J., Lerakis, Stamatios, Gutiérrez-Ibanes, Enrique, Abdel-Wahab, Mohamed, Tchetche, Didier, Testa, Luca, Eltchaninoff, Helene, Livi, Ugolino, Castillo, Juan Carlos, Jilaihawi, Hasan, Webb, John G., Barbanti, Marco, Kodali, Susheel, De Brito, Fabio S., Ribeiro, Henrique B., Miceli, Antonio, Fiorina, Claudia, Actis Dato, Guglielmo Mario, Rosato, Francesco, Serra, Vicenç, Masson, Jean Bernard, Wijeysundera, Harindra C., Mangione, Jose A., Ferreira, Maria Cristina, Lima, Valter C., Carvalho, Luis A., Abizaid, Alexandre, Marino, Marcos A., Esteves, Vinicius, Andrea, Julio C.M., Messika-Zeitoun, David, Himbert, Dominique, Kim, Won Keun, Pellegrini, Costanza, Auffret, Vincent, Nietlispach, Fabian, Pilgrim, Thomas, Durand, Eric, Lisko, John, Makkar, Raj R., Lemos, Pedro, Leon, Martin B., Puri, Rishi, San Roman, Alberto, Vahanian, Alec, Søndergaard, Lars, Mangner, Norman, and Rodés-Cabau, Josep

Abstract

Background: No data exist about the characteristics of infective endocarditis (IE) post-transcatheter aortic valve replacement (TAVR) according to transcatheter valve type. We aimed to determine the incidence, clinical characteristics, and outcomes of patients with IE post-TAVR treated with balloon-expandable valve (BEV) versus self-expanding valve (SEV) systems. Methods: Data from the multicenter Infectious Endocarditis After TAVR International Registry was used to compare IE patients with BEV versus SEV. Results: A total of 245 patients with IE post-TAVR were included (SEV, 47%; BEV, 53%). The timing between TAVR and IE was similar between groups (SEV, 5.5 [1.2-15] months versus BEV, 5.3 [1.7-11.4] months; P=0.89). Enterococcal IE was more frequent in the SEV group (36.5% versus 15.4%; P<0.01), and vegetation location differed according to valve type (stent frame, SEV, 18.6%; BEV, 6.9%; P=0.01; valve leaflet, SEV, 23.9%; BEV, 38.5%; P=0.01). BEV recipients had a higher rate of stroke/systemic embolism (20.0% versus 8.7%, adjusted OR: 2.46, 95% CI: 1.04-5.82, P=0.04). Surgical explant of the transcatheter valve (SEV, 8.7%; BEV, 13.8%; P=0.21), and in-hospital death at the time of IE episode (SEV, 35.6%; BEV, 37.7%; P=0.74) were similar between groups. After a mean follow-up of 13±12 months, 59.1% and 54.6% of the SEV and BEV recipients, respectively, had died (P=0.66). Conclusions: The characteristics of IE post-TAVR, including microorganism type, vegetation location, and embolic complications but not early or late mortality, differed according to valve type. These results may help to guide the diagnosis and management of IE and inform future research studies in the field.

Published
2019

47. Valve-in-Valve Implantation Using the ACURATE Neo in Degenerated Aortic Bioprostheses: An International Multicenter Analysis

Author

Team Medisch, Circulatory Health, Holzamer, Andreas, Kim, Won-Keun, Rück, Andreas, Sathananthan, Janarthanan, Keller, Lukas, Cosma, Joseph, Bauer, Timm, Nef, Holger, Amat-Santos, Ignacio J, Brinkert, Miriam, Husser, Oliver, Pellegrini, Costanza, Schofer, Joachim, Nerla, Roberto, Montorfano, Matteo, Giannini, Francesco, Stella, Pieter, Kuwata, Shingo, Hilker, Michael, Castriota, Fausto, Ussia, Gian Paolo, Webb, John G, Nietlispach, Fabian, Toggweiler, Stefan, Team Medisch, Circulatory Health, Holzamer, Andreas, Kim, Won-Keun, Rück, Andreas, Sathananthan, Janarthanan, Keller, Lukas, Cosma, Joseph, Bauer, Timm, Nef, Holger, Amat-Santos, Ignacio J, Brinkert, Miriam, Husser, Oliver, Pellegrini, Costanza, Schofer, Joachim, Nerla, Roberto, Montorfano, Matteo, Giannini, Francesco, Stella, Pieter, Kuwata, Shingo, Hilker, Michael, Castriota, Fausto, Ussia, Gian Paolo, Webb, John G, Nietlispach, Fabian, and Toggweiler, Stefan

Published
2019

48. TCT-713 Hemodynamic Valve Dysfunction Following Transcatheter Aortic Valve Implantation: Prevalence and Predictors of Elevated Transvalvular Gradients

Author

Rheude, Tobias, primary, Pellegrini, Costanza, additional, Cassese, Salvatore, additional, Wiebe, Jens, additional, Wagner, Sophia, additional, Michel, Jonathan, additional, Rumpf, Moritz, additional, Trenkwalder, Teresa, additional, Alvarez, Hector, additional, Mayr, N. Patrick, additional, Hengstenberg, Christian, additional, Kasel, Markus, additional, Schunkert, Heribert, additional, Kastrati, Adnan, additional, Husser, Oliver, additional, and Joner, Michael, additional

Published
2019
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50. Evaluación multicéntrica del sobredimensionamiento de la prótesis transcatéter SAPIEN 3. Impacto en el fallo del dispositivo y nuevos implantes de marcapasos

Author

Pellegrini, Costanza, primary, Kim, Won-Keun, additional, Holzamer, Andreas, additional, Walther, Thomas, additional, Mayr, N. Patrick, additional, Michel, Jonathan, additional, Rheude, Tobias, additional, Nuñez, Julio, additional, Kasel, Albert M., additional, Trenkwalder, Teresa, additional, Kaess, Bernhard M., additional, Joner, Michael, additional, Kastrati, Adnan, additional, Schunkert, Heribert, additional, Hilker, Michael, additional, Möllmann, Helge, additional, Hengstenberg, Christian, additional, and Husser, Oliver, additional

Published
2019
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