Prosthetic valve endocarditis after transcatheter aortic valve implantation-diagnostic and surgical considerations

Kazemi, Ahmad; Klaaborg, Kaj Erik; Hjortdal, Vibeke E.; Nørgaard, Bjarne Linde; Terkelsen, Christian Juhl; Jensen, Kimmo; Christiansen, Evald Høj; Terp, Kim; Andersen, G.R.; Hvitfeldt, Steen; Andersen, Henning

doi:10.21037/jtd.2016.10.28

Cited by 11 publications

(6 citation statements)

References 17 publications

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“…Our high incidence of floating structures demonstrated via echocardiography was similar to those of Amat-Santos et al [ 3 ] and Khalil Ahmad et al [ 13 ]. They most frequently found vegetations at the prosthetic valve.…”

Section: Discussionsupporting

confidence: 90%

Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis

Rösch

Brendel

Buschmann

et al. 2023

JCM

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Transcatheter aortic-valve replacement (TAVR) is increasingly being used for the treatment of aortic-valve stenosis. Therefore, the total number of patients with an aortic-valve prosthesis is increasing, causing the incidence of prosthetic-valve endocarditis to increase. Methods: Between March 2016 and July 2019, ten patients underwent surgery due to prosthetic-valve endocarditis after TAVR. They were identified in our institutional database and analyzed. Results: Infective endocarditis was diagnosed 17 ± 16 month after TAVR. Mean age was 79 ± 4.4 years. Microbiological detection showed 6/10 positive blood cultures for enterococcus faecalis. Median EuroScore II was 24.64%. The mean size of the surgically replaced aortic prosthesis was 23.6 ± 1.3 and that of the TAVR was 28.4 ± 2.3 mm. The surgically implanted aortic valves had a mean gradient of 8.5 ± 2.2 mmHg. One patient died in hospital due to septic multiorgan failure. After discharge, all patients survived with a mean follow-up of 9 ± 8 month. Conclusions: With a rising number of patients after TAVR, prosthetic-valve endocarditis will increasingly occur in patients who were previously considered high or intermediate risk. Our results show that patients with TAVR infective endocarditis can be operated on with good results. Surgical therapy should not be withheld from TAVR patients with infective endocarditis.

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Section: Discussionsupporting

confidence: 90%

Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis

Rösch

Brendel

Buschmann

et al. 2023

JCM

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“…Moreover, intubation, new pacemaker implantation, and CKD were risk factors for TAVI-IE (RR: 2.99, 95% CI 2.73 to 3.28; RR: 5.19, 95% CI 4.16 to 6.47; and RR: 1.17, 95% CI 1.05 to 1.29). Other variables showed no significant statistics and are presented in Table 2. A total of 51 articles which reported individual data of 157 patients were identified, 3 observational studies (Amat-Santos et al, 2015;Olsen et al, 2015;Rodriguez-Vidigal et al, 2018), 5 case series (Aung et al, 2013;Gallouche et al, 2018;Martinez-Selles et al, 2016;Puls et al, 2013;Scisło et al, 2019), 43 case reports (Ahmad et al, 2016;Campana et al, 2019;Carnero-Alcazar et al, 2010;Carrel and Eberle, 2019;Castiglioni et al, 2012;Cho et al, 2019;Chourdakis et al, 2017;Citro et al, 2013;Comoglio et al, 2009;Dapas et al, 2016;García-Pardo et al, 2012;Gonzalez et al, 2017;Gotzmann and Mugge, 2011;Gupta et al, 2019;Gürtler et al, 2019;Halapas et al, 2014;Head et al, 2011;Kesimci et al, 2014;Lane et al, 2015;Lee et al, 2014Lee et al, , 2019Loh et al, 2013;Loverix et al, 2013;Montero-Cruces et al, 2019;Mori et al, 2019;Morioka et al, 2019;Nguyen et al, 2019;Ochiai et al, 2016;Ohori et al, 2018;…”

Section: Resultsmentioning

confidence: 99%

Infective endocarditis after TAVI: a meta-analysis and systematic review of epidemiology, risk factors and clinical consequences

Tinică¹,

Tarus²,

Enache³

et al. 2020

Rev. Cardiovasc. Med.

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Infective endocarditis (IE) represents one of the most challenging clinical entities, requiring a multidisciplinary approach. The increasing number of surgical and transcatheter heart valves replacements performed annually lead to a higher incidence of prosthetic valve endocarditis. Transcatheter aortic valve implantation (TAVI) brought a new alternative for the treatment of aortic stenosis and a new subgroup of IE with its features. We aimed to compare the incidence of IE in TAVI and surgical valve replacement (SAVR) to identify risk factors for TAVI-IE, evaluate the possible impact on mortality, and clarify the best treatment strategies. A digital scan in PubMed and SCOPUS databases was performed. 68 publications were selected to perform a meta-analysis and systematic review on epidemiology, risk factors, and mortality predictors in TAVI-IE. No significant difference in IE rate was noted between patients with TAVI and those with SAVR for in-hospital, early, mid-term and late IE. Male gender, intubation, new pacemaker implantation IE and CKD were correlated with TAVI-IE. Surgical treatment was performed in 22.3% of cases. Overall mortality for the pooled cohort was 38.3%. In a multivariate logistic regression model, surgical treatment and self-expandable device were linked to lower mortality in TAVI-IE. Even if the invasive procedure can trigger bacteremia, exposing the TAVI valve to future infection, no significant difference in IE rate was noted in our analysis between patients with TAVI and those with SAVR for in-hospital, early, mid-term and late IE. Surgical treatment of TAVI-IE can be a viable option in patients with a prohibitive risk score.

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“…The surgical intervention did not influence the risk of mortality in this study. Collectively, SAVR for TAVI-PVE is occasionally considered in patients with uncontrolled infection or refractory heart failure, overgrown vegetation or abscess, aneurysmal formation or thromboembolic events (5).…”

Section: Clinical Resultsmentioning

confidence: 99%

Surgical aortic valve replacement due to infective endocarditis after transcatheter aortic valve implantation with the self-expanding Portico valve prosthesis

Sugimura

Katahira

Lopez

et al. 2019

Ann. Cardiothorac. Surg.

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Prosthetic valve endocarditis after transcatheter aortic valve implantation-diagnostic and surgical considerations

Cited by 11 publications

References 17 publications

Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis

Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement—A Retrospective Single-Center Analysis

Infective endocarditis after TAVI: a meta-analysis and systematic review of epidemiology, risk factors and clinical consequences

Surgical aortic valve replacement due to infective endocarditis after transcatheter aortic valve implantation with the self-expanding Portico valve prosthesis

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