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
N1 - Funding Information:
Dr Josep Rodés-Cabau has received institutional research grants from Edwards Lifesciences and Medtronic. Dr Tchetche has reported to receive consulting fees from Abbott Vascular, Boston Scientific, Edwards Lifesciencies, and Medtronic. Dr Webb has reported that he has received consulting fees from Edwards Lifescienc-es and St. Jude Medical. Dr Makkar has reported that he has received research grants from Edwards Lifesciences, Medtronic, Abbott, Capricor, and St. Jude Medical; has served as a proctor for Edwards Lifesciences; and has received consulting fees from Medtronic. Dr Kodali has reported that he has received consulting fees from Edwards Lifesciences; has served on the steering committees of Edwards Lifesciences and St. Jude Medical; has served on the Speakers’ Bureau of Thu-brikar Aortic Valve, Inc; and has equity in Thubrikar Aortic Valve. Dr Tamburino has reported that he has received support from Edwards Lifesciences, Abbott, and CardioKinetics; Dr Jilaihawi has reported that he has received consulting fees from Edwards Lifesciences, St. Jude Medical, and Venus Medtech. Dr de Brito has reported that he has received honoraria from Medtronic and Edwards Life-sciences for symposium speeches and proctoring cases. Dr Lerakis has reported that he has received consulting fees from Edwards Lifesciences. Dr Nietlispach has reported that he has received speaker and proctor fees from Abbott Vascular, Edwards Lifesciences and Medtronic. Dr Leon has reported that he has received research grants for clinical trials from Edwards Lifesciences. The other authors report no conflicts.
Publisher Copyright:
© 2019 American Heart Association, Inc.
PY - 2019/11/1
Y1 - 2019/11/1
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
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U2 - 10.1161/CIRCINTERVENTIONS.119.007938
DO - 10.1161/CIRCINTERVENTIONS.119.007938
M3 - Article
C2 - 31694412
AN - SCOPUS:85074626394
SN - 1941-7640
VL - 12
JO - Circulation: Cardiovascular Interventions
JF - Circulation: Cardiovascular Interventions
IS - 11
M1 - e007938
ER -