Infective Endocarditis following Transcatheter Aortic Valve Replacement: Comparison of Balloon-Versus Self-Expandable Valves

Ander Regueiro, Axel Linke, Azeem Latib, Nikolaj Ihlemann, Marina Urena, Thomas Walther, Oliver Husser, Howard C. Herrmann, Luis Nombela-Franco, Asim Cheema, Hervé Le Breton, Stefan Stortecky, Samir Kapadia, Antonio L. Bartorelli, Jan Malte Sinning, Ignacio Amat-Santos, Antonio J. Munoz-Garcia, Stamatios Lerakis, Enrique Gutiérrez-Ibanes, Mohamed Abdel-WahabDidier Tchetche, Luca Testa, Helene Eltchaninoff, Ugolino Livi, Juan Carlos Castillo, Hasan Jilaihawi, John G. Webb, Marco Barbanti, Susheel Kodali, Fabio S. De Brito, Henrique B. Ribeiro, Antonio Miceli, Claudia Fiorina, Guglielmo Mario Actis Dato, Francesco Rosato, Vicenç Serra, Jean Bernard Masson, Harindra C. Wijeysundera, Jose A. Mangione, Maria Cristina Ferreira, Valter C. Lima, Luis A. Carvalho, Alexandre Abizaid, Marcos A. Marino, Vinicius Esteves, Julio C.M. Andrea, David Messika-Zeitoun, Dominique Himbert, Won Keun Kim, Costanza Pellegrini, Vincent Auffret, Fabian Nietlispach, Thomas Pilgrim, Eric Durand, John Lisko, Raj R. Makkar, Pedro Lemos, Martin B. Leon, Rishi Puri, Alberto San Roman, Alec Vahanian, Lars Søndergaard, Norman Mangner, Josep Rodés-Cabau

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article numbere007938
JournalCirculation: Cardiovascular Interventions
Volume12
Issue number11
DOIs
StatePublished - Nov 1 2019
Externally publishedYes

Keywords

  • endocarditis
  • incidence
  • registry
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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