Prosthetic valve endocarditis after transcatheter or surgical aortic valve replacement with a bioprosthesis: results from the FinnValve Registry

Moriyama, Noriaki; Laakso, Teemu; Biancari, Fausto; Raivio, Peter; Jalava, Maina P.; Jaakkola, Samuli; Dahlbacka, Sebastian; Kinnunen, Esko; Juvonen, Tatu; Husso, Annastiina; Niemelä, Matti; Ahvenvaara, Tuomas; Tauriainen, Tuomas; Virtanen, Marko; Maaranen, Pasi; Eskola, Markku; Rosato, Stefano; Mäkikallio, Timo H.; Savontaus, Mikko; Valtola, Antti; Anttila, Vesa; Airaksinen, Juhani; Laine, Mika

doi:10.4244/eij-d-19-00247

Cited by 50 publications

(44 citation statements)

References 39 publications

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“…Both staphylococci and streptococci were isolated in about 30% of cases and Enterococcus was found in one-fourth of the patients. These results fully align with previous findings in patients with TAVI infective endocarditis [11,16,58,59].…”

Section: Discussionsupporting

confidence: 92%

“…Infection of TAVI prostheses is not uncommon, with a reported incidence of 0.5-1.6% per year in populations followed up to 5 years; the concomitant survival rate is 40-50% [12,[54][55][56]. Review papers [18,57,58] and analyses of national and international registries [11][12][13][14]16] have started delineating the common features of TAVI prosthesis infection and have ultimately highlighted two important findings: patients with TAVI endocarditis suffer a dismal early outcome with a mortality of 40-70% at 1 year after the diagnosis, and surgical explantation of the infected prosthesis was performed in only 2-14% of cases despite clear indications for surgical intervention in more than 80% of patients [11,13,14,16,41,59]. Reasons for not operating include a remarkably high clinical or surgical risk, need for additional procedures, advanced age of the patient and limited life expectancy, multiorgan failure, septicaemia and dismal long-term prognosis.…”

Section: Discussionmentioning

confidence: 99%

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Surgical treatment of transcatheter aortic valve infective endocarditis

et al. 2020

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There is growing interest in infections occurring after transcatheter aortic valve implantation (TAVI). The incidence, and clinical and anatomical features suggest many similarities with prosthetic valve endocarditis. The survival of patients with an infected TAVI prosthesis is generally poor; however, only a minority of them (10%) have undergone treatment with surgical explantation of the infected prosthesis. A literature search was performed using online databases. Papers reporting surgical treatment of TAVI prosthesis infections were retrieved, focusing on pre- and intraoperative characteristics and early outcome. Thirty-seven papers ultimately provided information on 107 patients. Their mean ± standard deviation (SD) age was 76 ± 8 years and 72% were male. The mean ± SD time interval between the TAVI procedure and reoperation was 10 ± 10 months. Annular abscess formation was described in 34% of cases and mitral valve involvement in 31%. All patients underwent TAVI prosthesis explantation and surgical aortic valve replacement; concomitant mitral valve replacement was necessary in 22% of cases. Postoperative in-hospital mortality was 28%. Surgical explantation of infected TAVI prostheses was associated with a high postoperative mortality, although these initial experiences included elderly and high-risk patients. Considering the expansion of TAVI procedures towards younger and lower-risk patients, surgical treatment of TAVI endocarditis may represent the best option for a life-saving procedure.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Surgical treatment of transcatheter aortic valve infective endocarditis

et al. 2020

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“…A temporary pacing lead may also be an entry point for bacteria into the bloodstream. Staphylococcus aureus was the cause of PVE in 25% of the patients, which was comparable with the findings of other studies [17,23].…”

Section: Discussionsupporting

confidence: 91%

Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands

et al. 2020

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Background Transcatheter aortic valve replacement (TAVR) is increasingly being used as an alternative to conventional surgical valve replacement. Prosthetic valve endocarditis (PVE) is a rare but feared complication after TAVR, with reported first-year incidences varying from 0.57 to 3.1%. This study was performed to gain insight into the incidence and outcome of PVE after TAVR in the Netherlands.

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“…Mortality in IE is one of the highest among heart-related diseases; it can reach up to 24% for native valve IE (Cresti et al, 2017) and surpass 46% for PVE (Akowuah et al, 2003). Moriyama et al (2019) reported 30-days and one-year mortality in TAVI-IE of 37.7% and 52.5%. In the pooled series, it was 38.3% for overall reported follow up.…”

Section: Discussionmentioning

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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Prosthetic valve endocarditis after transcatheter or surgical aortic valve replacement with a bioprosthesis: results from the FinnValve Registry

Cited by 50 publications

References 39 publications

Surgical treatment of transcatheter aortic valve infective endocarditis

Surgical treatment of transcatheter aortic valve infective endocarditis

Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands

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

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