TY - JOUR

T1 - Infective Endocarditis Following Transcatheter Aortic Valve Replacement

T2 - Comparison of Balloon-Versus Self-Expandable Valves

AU - Regueiro, Ander

AU - Linke, Axel

AU - Latib, Azeem

AU - Ihlemann, Nikolaj

AU - Urena, Marina

AU - Walther, Thomas

AU - Husser, Oliver

AU - Herrmann, Howard C.

AU - Nombela-Franco, Luis

AU - Cheema, Asim

AU - Le Breton, Hervé

AU - Stortecky, Stefan

AU - Kapadia, Samir

AU - Bartorelli, Antonio L.

AU - Sinning, Jan Malte

AU - Amat-Santos, Ignacio

AU - Munoz-Garcia, Antonio J.

AU - Lerakis, Stamatios

AU - Gutiérrez-Ibanes, Enrique

AU - Abdel-Wahab, Mohamed

AU - Tchetche, Didier

AU - Testa, Luca

AU - Eltchaninoff, Helene

AU - Livi, Ugolino

AU - Castillo, Juan Carlos

AU - Jilaihawi, Hasan

AU - Webb, John G.

AU - Barbanti, Marco

AU - Kodali, Susheel

AU - De Brito, Fabio S.

AU - Ribeiro, Henrique B.

AU - Miceli, Antonio

AU - Fiorina, Claudia

AU - Actis Dato, Guglielmo Mario

AU - Rosato, Francesco

AU - Serra, Vicenç

AU - Masson, Jean Bernard

AU - Wijeysundera, Harindra C.

AU - Mangione, Jose A.

AU - Ferreira, Maria Cristina

AU - Lima, Valter C.

AU - Carvalho, Luis A.

AU - Abizaid, Alexandre

AU - Marino, Marcos A.

AU - Esteves, Vinicius

AU - Andrea, Julio C.M.

AU - Messika-Zeitoun, David

AU - Himbert, Dominique

AU - Kim, Won Keun

AU - Pellegrini, Costanza

AU - Auffret, Vincent

AU - Nietlispach, Fabian

AU - Pilgrim, Thomas

AU - Durand, Eric

AU - Lisko, John

AU - Makkar, Raj R.

AU - Lemos, Pedro

AU - Leon, Martin B.

AU - Puri, Rishi

AU - San Roman, Alberto

AU - Vahanian, Alec

AU - Søndergaard, Lars

AU - Mangner, Norman

AU - Rodés-Cabau, Josep

PY - 2019/11

Y1 - 2019/11

N2 - Background: No data exist about the characteristics of infective endocarditis (IE) post-transcatheter aortic valve replacement (TAVR) according to transcatheter valve type. We aimed to determine the incidence, clinical characteristics, and outcomes of patients with IE post-TAVR treated with balloon-expandable valve (BEV) versus self-expanding valve (SEV) systems. Methods: Data from the multicenter Infectious Endocarditis After TAVR International Registry was used to compare IE patients with BEV versus SEV. Results: A total of 245 patients with IE post-TAVR were included (SEV, 47%; BEV, 53%). The timing between TAVR and IE was similar between groups (SEV, 5.5 [1.2-15] months versus BEV, 5.3 [1.7-11.4] months; P=0.89). Enterococcal IE was more frequent in the SEV group (36.5% versus 15.4%; P<0.01), and vegetation location differed according to valve type (stent frame, SEV, 18.6%; BEV, 6.9%; P=0.01; valve leaflet, SEV, 23.9%; BEV, 38.5%; P=0.01). BEV recipients had a higher rate of stroke/systemic embolism (20.0% versus 8.7%, adjusted OR: 2.46, 95% CI: 1.04-5.82, P=0.04). Surgical explant of the transcatheter valve (SEV, 8.7%; BEV, 13.8%; P=0.21), and in-hospital death at the time of IE episode (SEV, 35.6%; BEV, 37.7%; P=0.74) were similar between groups. After a mean follow-up of 13±12 months, 59.1% and 54.6% of the SEV and BEV recipients, respectively, had died (P=0.66). Conclusions: The characteristics of IE post-TAVR, including microorganism type, vegetation location, and embolic complications but not early or late mortality, differed according to valve type. These results may help to guide the diagnosis and management of IE and inform future research studies in the field.

AB - Background: No data exist about the characteristics of infective endocarditis (IE) post-transcatheter aortic valve replacement (TAVR) according to transcatheter valve type. We aimed to determine the incidence, clinical characteristics, and outcomes of patients with IE post-TAVR treated with balloon-expandable valve (BEV) versus self-expanding valve (SEV) systems. Methods: Data from the multicenter Infectious Endocarditis After TAVR International Registry was used to compare IE patients with BEV versus SEV. Results: A total of 245 patients with IE post-TAVR were included (SEV, 47%; BEV, 53%). The timing between TAVR and IE was similar between groups (SEV, 5.5 [1.2-15] months versus BEV, 5.3 [1.7-11.4] months; P=0.89). Enterococcal IE was more frequent in the SEV group (36.5% versus 15.4%; P<0.01), and vegetation location differed according to valve type (stent frame, SEV, 18.6%; BEV, 6.9%; P=0.01; valve leaflet, SEV, 23.9%; BEV, 38.5%; P=0.01). BEV recipients had a higher rate of stroke/systemic embolism (20.0% versus 8.7%, adjusted OR: 2.46, 95% CI: 1.04-5.82, P=0.04). Surgical explant of the transcatheter valve (SEV, 8.7%; BEV, 13.8%; P=0.21), and in-hospital death at the time of IE episode (SEV, 35.6%; BEV, 37.7%; P=0.74) were similar between groups. After a mean follow-up of 13±12 months, 59.1% and 54.6% of the SEV and BEV recipients, respectively, had died (P=0.66). Conclusions: The characteristics of IE post-TAVR, including microorganism type, vegetation location, and embolic complications but not early or late mortality, differed according to valve type. These results may help to guide the diagnosis and management of IE and inform future research studies in the field.

KW - endocarditis

KW - incidence

KW - registry

KW - transcatheter aortic valve replacement

U2 - 10.1161/CIRCINTERVENTIONS.119.007938

DO - 10.1161/CIRCINTERVENTIONS.119.007938

M3 - Journal article

C2 - 31694412

AN - SCOPUS:85074626394

VL - 12

JO - Circulation: Cardiovascular Interventions

JF - Circulation: Cardiovascular Interventions

SN - 1941-7640

IS - 11

M1 - e007938

ER -