The risk of bacterial endocarditis after percutaneous and surgical biological pulmonary valve implantation

Haas, Nikolaus A.; Bach, Sissi; Vcasna, R.; Laser, Kai Thorsten; Sandica, Eugen; Blanz, Ute; Jakob, André; Dietl, Markus; Fischer, Marcus; Kanaan, M.; Lehner, Anja

doi:10.1016/j.ijcard.2018.04.138

Cited by 36 publications

(40 citation statements)

References 40 publications

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“…Van Dijck et al [42] found in a large national cohort study an increased risk of IE for the same biological substrate (Contegra 1 Conduit and Melody 1 valve) when related to homografts. Haas et al [27] could demonstrate a significantly increased IE risk for Contegra 1 conduits and Melody 1 valves when compared to other biological pulmonary valve substrates (i.e. homografts, Sapien TM valves, and Hancock valves).…”

Section: Possible Explantationsmentioning

confidence: 98%

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The risk of infective endocarditis following interventional pulmonary valve implantation: A meta-analysis

Lehner

Haas

Dietl

et al. 2019

Journal of Cardiology

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Background: Interventional percutaneous pulmonary valve implantation (PPVI) was first reported in 2000. Today, two different valves are certified for this procedure [i.e. Medtronic Melody 1 valve (Medtronic, Dublin, Ireland) and Edwards Sapien TM valve (Edwards Lifesciences, Irvine, CA, USA)]. For a decade, studies have reported an increasing risk of infective endocarditis (IE) after PPVI; as patients for PPVI are usually younger, even a low annual incidence of IE is important. However, the overall incidence and potential differences between the valves remain unclear. Methods: A systematic literature search was performed in the databases Medline, Cochrane Library, and Embase including the clinical trials register. The aim was to summarize and compare the cumulative incidence of IE after PPVI. Using a sensitivity analysis we set the incidence rates of the two valve types in ratio with a normal population. Results: A total of 967 publications were identified searching for "pulmonary valve implantation," "PPVI," and 47 publications were used for final analysis. A total 3616 patients with Melody 1 valves and 501 with Sapien TM valves were included. IE after PPVI occurred in 214 patients with Melody 1 valves and in 5 patients only with Sapien TM valves. The pooled incidence for Melody 1 and Sapien TM valves was 4.9% (95% CI: 3.6-6.2) and 1.3% (95% CI: 0.3-2.3), respectively. Chi-square test was significant. The sensitivity analysis showed that the incidence rate ratio was 252.1 (95% CI: 187.6-338.6) for Melody 1 valves and for Sapien TM valves 2.7 (95% CI: 0.8-9.2). Conclusions: At present, there is an important difference for the risk of IE after PPVI. To reduce the risk of post PPVI endocarditis, a careful valve selection in favor of the Sapien TM valves seems to be beneficial.

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Section: Possible Explantationsmentioning

confidence: 98%

“…There was however a notable variation in the reports of IE in the Melody 1 studies. The largest Incidence of IE was 27%; only 5 studies [15,27,28,39,41] did not observe IE cases.…”

Section: Meta-analysis Of Cohort Studiesmentioning

confidence: 98%

The risk of infective endocarditis following interventional pulmonary valve implantation: A meta-analysis

Lehner

Haas

Dietl

et al. 2019

Journal of Cardiology

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“…Although the results from different studies were not consistent, the BJVC showed similar or even better durability than that of cryopreserved homograft for RVOT reconstruction. However, the BJVC has greater incidence of late endocarditis after being implanted, with a rate of 4.7% to 9.9% reported in previous studies (16,(46)(47)(48). The endocarditis seems to be a unique situation that occurs in glutaraldehyde-treated bovine jugular vein products (49).…”

Section: Bovine Jugular Vein Conduitmentioning

confidence: 91%

Conduits for Right Ventricular Outflow Tract Reconstruction in Infants and Young Children

et al. 2021

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Purpose of Review: Right ventricular outflow tract (RVOT) reconstruction remains a challenge due to the lack of an ideal conduit. Data and experience are accumulating with each passing day. Therefore, it is necessary to review this topic from time to time. This is a 2021 update review focused on the history, evolution, and current situation of small-sized conduits (≤ 16 mm) for RVOT reconstruction in infants and young children.Recent Findings: Currently, the available small-sized (≤16 mm) conduits can meet most clinical needs. Homograft is still a reliable choice for infants and young children validated by a half-century clinical experience. As an alternative material, bovine jugular vein conduit (BJVC) has at least comparable durability with that of homograft. The performance of expanded polytetrafluoroethylene (ePTFE) is amazing in RVOT position according to limited published data. The past century has witnessed much progress in the materials for RVOT reconstruction. However, lack of growth potential is the dilemma for small-sized conduits. Tissue-engineering based on cell-free scaffolds is the most promising technology to obtain the ideal conduit.Summary: No conduit has proved to have lifelong durability in RVOT position. We are far from the ideal, but we are not in a state of emergency. In-depth clinical research as well as innovation in material science are needed to help improve the durability of the conduits used in infants and young children.

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“…In a recent publication of Haas et al . [ 71 ] the risk of bacterial endocarditis was 5-8- times higher for Melody valves compared to other valves in a group of 246 patients with all types of pulmonary valves. There was no bacterial endocarditis in the patients treated with Sapien valves during follow-up.…”

Section: Methodsmentioning

confidence: 99%

Percutaneous Pulmonary Valve Implantation: Current Status and Future Perspectives

Driesen

Warmerdam

Sieswerda

et al. 2019

CCR

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Patients with congenital heart disease (CHD) with right ventricle outflow tract (RVOT) dysfunction need sequential pulmonary valve replacements throughout their life in the majority of cases. Since their introduction in 2000, the number of percutaneous pulmonary valve implantations (PPVI) has grown and reached over 10,000 procedures worldwide. Overall, PPVI has been proven safe and effective, but some anatomical variations can limit procedural success. This review discusses the current status and future perspectives of the procedure.

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The risk of bacterial endocarditis after percutaneous and surgical biological pulmonary valve implantation

Cited by 36 publications

References 40 publications

The risk of infective endocarditis following interventional pulmonary valve implantation: A meta-analysis

The risk of infective endocarditis following interventional pulmonary valve implantation: A meta-analysis

Conduits for Right Ventricular Outflow Tract Reconstruction in Infants and Young Children

Percutaneous Pulmonary Valve Implantation: Current Status and Future Perspectives

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