Infective endocarditis of a transcatheter pulmonary valve in comparison with surgical implants

Dijck, Ine Van; Budts, Werner; Cools, Björn; Eyskens, Bénédicte; Boshoff, Derize; Heying, Ruth; Frerich, Stefan; Vanagt, Ward Y.; Troost, Els; Gewillig, Marc

doi:10.1136/heartjnl-2014-306761

Cited by 170 publications

(148 citation statements)

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“…Both cumulative and annualized incidences of IE were higher in studies with lower numbers of patients (Figure 1A and 1B14, 15, 16, 17, 18, 19, 20, 21, 22). On the other hand, the incidence was not influenced by the follow‐up duration (Figure 2A and 2B14, 15, 16, 17, 18, 19, 20, 21, 22). Figure 3 shows a summary of the time period of patient enrollment in each study and the respective cumulative (Figure 3A14, 15, 16, 17, 18, 19, 20, 21, 22) and annualized incidence rate of IE (Figure 3B14, 15, 16, 17, 18, 19, 20, 21, 22), both trending to be higher in later than in earlier studies.…”

Section: Resultsmentioning

confidence: 96%

“…A total of 9 studies14, 15, 16, 17, 18, 19, 20, 21, 22 were included in the analysis of the incidence of IE after TPVI using the Melody valve. The characteristics of the studies are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…In studies applying the modified Duke criteria (n=4 studies16, 19, 21, 22), the cumulative incidence of IE ranged from 7.5% to 25.0%, and the annualized incidence rate ranged from 3.7% to 6.3%. Both cumulative and annualized incidences of IE were higher in studies with lower numbers of patients (Figure 1A and 1B14, 15, 16, 17, 18, 19, 20, 21, 22). On the other hand, the incidence was not influenced by the follow‐up duration (Figure 2A and 2B14, 15, 16, 17, 18, 19, 20, 21, 22).…”

Section: Resultsmentioning

confidence: 99%

“…Scatter plots of the cumulative (A) and annualized (B) incidence rate of infective endocarditis ( IE ) plotted against the sample size (number of patients) of the individual studies14, 15, 16, 17, 18, 19, 20, 21, 22 (Spearman correlation coefficient=−0.80 and −0.73, P =0.010 and P =0.025, respectively).…”

Section: Resultsmentioning

confidence: 99%

“…AS indicates aortic stenosis; IE, infective endocarditis; HACEK, Haemophilus parainfluenzae, H. aphrophilus, H. paraphrophilus, H. influenzae, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae, and K. denitrificans; PG, pressure gradient; PR, pulmonary regurgitation; RVOT, right ventricular outflow tract; S/P, status post; TA, truncus arteriosus; TGA, transposition of the great arteries; TOF, tetralogy of Fallot; TPVI, transcatheter pulmonary valve implantation.aFrom 22 reports published between 2011 and 2017 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38b

Corynebacterium pseudodiphtheriticum in 3 cases and Corynebacterium striatum in 1 case.

Haemophilus influenzae in 1 case and Haemophilus parainfluenzae in another case.

In 3 cases, serologic findings and polymerase chain reaction of excised valves revealed Bartonella henselae .

…”

Section: Resultsmentioning

confidence: 99%

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Infective Endocarditis After Melody Valve Implantation in the Pulmonary Position: A Systematic Review

Abdelghani

Nassif

Blom

et al. 2018

JAHA

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BackgroundInfective endocarditis (IE) after transcatheter pulmonary valve implantation (TPVI) in dysfunctioning right ventricular outflow tract conduits has evoked growing concerns. We aimed to investigate the incidence and the natural history of IE after TPVI with the Melody valve through a systematic review of published data.Methods and ResultsPubMed, EMBASE, and Web of Science databases were systematically searched for articles published until March 2017, reporting on IE after TPVI with the Melody valve. Nine studies (including 851 patients and 2060 patient‐years of follow‐up) were included in the analysis of the incidence of IE. The cumulative incidence of IE ranged from 3.2% to 25.0%, whereas the annualized incidence rate ranged from 1.3% to 9.1% per patient‐year. The median (interquartile range) time from TPVI to the onset of IE was 18.0 (9.0–30.4) months (range, 1.0–72.0 months). The most common findings were positive blood culture (93%), fever (89%), and new, significant, and/or progressive right ventricular outflow tract obstruction (79%); vegetations were detectable on echocardiography in only 34% of cases. Of 69 patients with IE after TPVI, 6 (8.7%) died and 35 (52%) underwent surgical and/or transcatheter reintervention. Death or reintervention was more common in patients with new/significant right ventricular outflow tract obstruction (69% versus 33%; P=0.042) and in patients with non‐streptococcal IE (73% versus 30%; P=0.001).ConclusionsThe incidence of IE after implantation of a Melody valve is significant, at least over the first 3 years after TPVI, and varies considerably between the studies. Although surgical/percutaneous reintervention is a common consequence, some patients can be managed medically, especially those with streptococcal infection and no right ventricular outflow tract obstruction.

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