MitraClip-Associated Endocarditis: Emergency Department Diagnosis With Point of Care Ultrasound

Rempfer, Elizabeth; Basinger, Hayden; Stawovy, L.E.; End, Bradley; Shockcor, William; Minardi, Joseph

doi:10.1016/j.jemermed.2020.02.016

Cited by 6 publications

(2 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our search strategy included the use of the terms “infective endocarditis or infectious endocarditis” and “transcatheter mitral valve repair, percutaneous mitral valve repair, MitraClip, or PASCAL.” A manual search for these topics within case reports at major cardiology meetings was also performed until February 2023. A total of 23 publications describing 26 cases of IE following TEER treatment for severe MR were identified, 7–29 in addition to our one case. Our local ethics committee approved this case report and systematic review.…”

Section: Systematic Reviewmentioning

confidence: 99%

Infective endocarditis after transcatheter edge‐to‐edge repair for severe mitral regurgitation; a case report and a systematic review

Yokoyama

Ochiai

Saito

2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

Transcatheter edge‐to‐edge repair (TEER) is used extensively in patients with symptomatic severe mitral regurgitation and high surgical risk. While prosthetic valve endocarditis is well documented, infective endocarditis (IE) after TEER is a rare occurrence. To date, no study has been conducted on this complication. We report the case of an 85‐year‐old man who developed IE 3 months after undergoing TEER, and we systematically review 26 previously published cases of this complication. Our review findings indicate that discussion within the heart team is essential for the decision‐making process and treatment strategy determination.

show abstract

Section: Systematic Reviewmentioning

confidence: 99%

Infective endocarditis after transcatheter edge‐to‐edge repair for severe mitral regurgitation; a case report and a systematic review

Yokoyama

Ochiai

Saito

2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…Undoubtedly, the mentioned clinical features influence the high mortality associated with MitraClip-related IE, as they are reported to be among the predictors of poor outcome [ 20 ]. Upon pooling of available literature data, we were able to appreciate that the clinical presentation of MitraClip-related IE is dominated by classical symptoms of systemic infection (fever in 15/25 pts; 60%) together with signs and symptoms of decompensated heart failure (12/25 pts; 48%) [ 6 , 15 , 16 , 21 , 22 , 23 , 24 , 25 , 26 ], resulting from mitral valve recurrent regurgitation or stenosis. Less common presentations included complete heart block (one case) [ 27 ], whilst septic emboli seldom occurred (3/25 pts; 12%) [ 28 , 29 ].…”

Section: Mitraclipmentioning

confidence: 99%

Emerging Concepts on Infection of Novel Cardiac Implantable Devices

Ramadan¹,

Gallo²,

Patauner³

et al. 2022

Rev. Cardiovasc. Med.

View full text Add to dashboard Cite

Novel cardiac devices, including the MitraClip system, occluder devices, leadless pacemakers, and subcutaneous implantable cardioverter defibrillators (S-ICD), are mostly used in the management of patients who are at high risk for surgery and/or developing infections. Several mechanisms render most of these devices resistant to infection, including avoiding long transvenous access and novel manufacturing material. Since subjects who use these devices already endure several comorbid conditions, uncommon cases of device-associated infection could result in serious complications and increased mortality. In this review, we aim to summarize the current state of evidence on the incidence, clinical presentation, management, and prognosis of new cardiac devices' associated infection.

et al. 2023

View full text Add to dashboard Cite

Purpose Progress of interventional cardiology has boosted the use of newer cardiac devices. These devices are perceived to be less prone to infections compared to traditional surgical prostheses, but little data are currently available. In this systematic review (SR), we summarize current literature regarding the clinical characteristics, management, and outcomes of patients with MitraClip-related infective endocarditis (IE). Methods We conducted a SR of PubMed, Google Scholar, Embase, and Scopus between January 2003 and March 2022. MitraClip-related IE was defined according to 2015 ESC criteria whereas MitraClip involvement as vegetation on the device or on the mitral valve. Risk of bias was assessed through standardized checklist and potential bias of underestimation cannot be excluded. Data regarding clinical presentation, echocardiography, management, and outcome were collected. Results Twenty-six cases of MitraClip-related IE were retrieved. The median age of patients was 76 [61–83] years with a median EuroScore of 41%. Fever was present in 65.8% of patients followed by signs and symptoms of heart failure (42.3%). IE occurred early in 20 (76.9%) cases with a median time between MitraClip implantation and IE symptom onset of 5 [2–16] months. Staphylococcus aureus was the major causative microorganism (46%). Surgical mitral valve replacement was needed in 50% of patients. A conservative medical approach was considered in the remainder. The overall in-hospital mortality rate was 50% (surgical group: 38.4%; medical group: 58.3%; p = 0.433). Conclusion Our results suggest that MitraClip-related IE affects elderly, comorbid patients, is mostly due to Staphylococcus aureus, and has a poor prognosis irrespective of the therapeutic approach. Clinicians must be aware of the features of this new entity among cardiovascular infections.

show abstract

MitraClip-Associated Endocarditis: Emergency Department Diagnosis With Point of Care Ultrasound

Cited by 6 publications

References 26 publications

Infective endocarditis after transcatheter edge‐to‐edge repair for severe mitral regurgitation; a case report and a systematic review

Infective endocarditis after transcatheter edge‐to‐edge repair for severe mitral regurgitation; a case report and a systematic review

Emerging Concepts on Infection of Novel Cardiac Implantable Devices

Infective endocarditis involving MitraClip© devices: a systematic literature review

Contact Info

Product

Resources

About