Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement

Vassili Panagides; David del Val; Mohamed Abdel-Wahab; Norman Mangner; Eric Durand; Nikolaj Ihlemann; Marina Urena; Costanza Pellegrini; Francesco Giannini; Tomasz Gasior; Wojtek Wojakowski; Martin Landt; Vincent Auffret; Jan Malte Sinning; Asim N. Cheema; Luis Nombela-Franco; Chekrallah Chamandi; Francisco Campelo-Parada; Erika Munoz-Garcia; Howard C. Herrmann; Luca Testa; Won Keun Kim; Juan Carlos Castillo; Alberto Alperi; Didier Tchetche; Antonio L. Bartorelli; Samir Kapadia; Stefan Stortecky; Ignacio Amat-Santos; Harindra C. Wijeysundera; John Lisko; Enrique Gutiérrez-Ibanes; Vicenç Serra; Luisa Salido; Abdullah Alkhodair; Ugolino Livi; Tarun Chakravarty; Stamatios Lerakis; Victoria Vilalta; Ander Regueiro; Rafael Romaguera; Utz Kappert; Marco Barbanti; Jean Bernard Masson; Frédéric Maes; Claudia Fiorina; Antonio Miceli; Susheel Kodali; Henrique B. Ribeiro; Jose Armando Mangione; Fabio Sandoli De Brito; Guglielmo Mario Actis Dato; Francesco Rosato; Maria Cristina Ferreira; Valter Correia de Lima; Alexandre Siciliano Colafranceschi; Alexandre Abizaid; Marcos Antonio Marino; Vinicius Esteves; Julio Andrea; Roger R. Godinho; Fernando Alfonso; Helene Eltchaninoff; Lars Søndergaard; Dominique Himbert; Oliver Husser; Azeem Latib; Hervé Le Breton; Clement Servoz; Isaac Pascual; Saif Siddiqui; Paolo Olivares; Rosana Hernandez-Antolin; John G. Webb; Sandro Sponga; Raj Makkar; Annapoorna S. Kini; Marouane Boukhris; Philippe Gervais; Axel Linke; Lisa Crusius; David Holzhey; Josep Rodés-Cabau

doi:10.1093/cid/ciab1004

Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement

Vassili Panagides, David del Val, Mohamed Abdel-Wahab, Norman Mangner, Eric Durand, Nikolaj Ihlemann, Marina Urena, Costanza Pellegrini, Francesco Giannini, Tomasz Gasior, Wojtek Wojakowski, Martin Landt, Vincent Auffret, Jan Malte Sinning, Asim N. Cheema, Luis Nombela-Franco, Chekrallah Chamandi, Francisco Campelo-Parada, Erika Munoz-Garcia, Howard C. HerrmannLuca Testa, Won Keun Kim, Juan Carlos Castillo, Alberto Alperi, Didier Tchetche, Antonio L. Bartorelli, Samir Kapadia, Stefan Stortecky, Ignacio Amat-Santos, Harindra C. Wijeysundera, John Lisko, Enrique Gutiérrez-Ibanes, Vicenç Serra, Luisa Salido, Abdullah Alkhodair, Ugolino Livi, Tarun Chakravarty, Stamatios Lerakis, Victoria Vilalta, Ander Regueiro, Rafael Romaguera, Utz Kappert, Marco Barbanti, Jean Bernard Masson, Frédéric Maes, Claudia Fiorina, Antonio Miceli, Susheel Kodali, Henrique B. Ribeiro, Jose Armando Mangione, Fabio Sandoli De Brito, Guglielmo Mario Actis Dato, Francesco Rosato, Maria Cristina Ferreira, Valter Correia de Lima, Alexandre Siciliano Colafranceschi, Alexandre Abizaid, Marcos Antonio Marino, Vinicius Esteves, Julio Andrea, Roger R. Godinho, Fernando Alfonso, Helene Eltchaninoff, Lars Søndergaard, Dominique Himbert, Oliver Husser, Azeem Latib, Hervé Le Breton, Clement Servoz, Isaac Pascual, Saif Siddiqui, Paolo Olivares, Rosana Hernandez-Antolin, John G. Webb, Sandro Sponga, Raj Makkar, Annapoorna S. Kini, Marouane Boukhris, Philippe Gervais, Axel Linke, Lisa Crusius, David Holzhey, Josep Rodés-Cabau

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Background. Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients. Methods. This multicenter study included 579 patients who had the diagnosis of definite IE at a median of 171 (53–421) days following TAVR. PEE was defined as the presence of an intracardiac abscess, pseudoaneurysm, or fistula. Results. A total of 105 patients (18.1%) were diagnosed with PEE (perivalvular abscess, pseudoaneurysm, fistula, or a combination in 87, 7, 7, and 4 patients, respectively). A history of chronic kidney disease (adjusted odds ratio [OR_adj], 2.08; 95% confidence interval [CI]: 1.27–3.41; P = .003) and IE secondary to coagulase-negative staphylococci (OR_adj, 2.71; 95% CI: 1.57–4.69; P < .001) were associated with an increased risk of PEE. Surgery was performed at index IE episode in 34 patients (32.4%) with PEE (vs 15.2% in patients without PEE, P < .001). In-hospital and 2-year mortality rates among PEE-IE patients were 36.5% and 69.4%, respectively. Factors independently associated with an increased mortality were the occurrence of other complications (stroke post-TAVR, acute renal failure, septic shock) and the lack of surgery at index IE hospitalization (p_adj < 0.05 for all). Conclusions. PEE occurred in about one-fifth of IE post-TAVR patients, with the presence of coagulase-negative staphylococci and chronic kidney disease determining an increased risk. Patients with PEE-IE exhibited high early and late mortality rates, and surgery during IE hospitalization seemed to be associated with better outcomes.

Original language	English (US)
Pages (from-to)	638-646
Number of pages	9
Journal	Clinical Infectious Diseases
Volume	75
Issue number	4
DOIs	https://doi.org/10.1093/cid/ciab1004
State	Published - Aug 15 2022
Externally published	Yes

Keywords

TAVI
TAVR
heart surgery
infective endocarditis

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/cid/ciab1004

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Panagides, V., del Val, D., Abdel-Wahab, M., Mangner, N., Durand, E., Ihlemann, N., Urena, M., Pellegrini, C., Giannini, F., Gasior, T., Wojakowski, W., Landt, M., Auffret, V., Sinning, J. M., Cheema, A. N., Nombela-Franco, L., Chamandi, C., Campelo-Parada, F., Munoz-Garcia, E., ... Rodés-Cabau, J. (2022). Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement. Clinical Infectious Diseases, 75(4), 638-646. https://doi.org/10.1093/cid/ciab1004

Panagides, V, del Val, D, Abdel-Wahab, M, Mangner, N, Durand, E, Ihlemann, N, Urena, M, Pellegrini, C, Giannini, F, Gasior, T, Wojakowski, W, Landt, M, Auffret, V, Sinning, JM, Cheema, AN, Nombela-Franco, L, Chamandi, C, Campelo-Parada, F, Munoz-Garcia, E, Herrmann, HC, Testa, L, Kim, WK, Castillo, JC, Alperi, A, Tchetche, D, Bartorelli, AL, Kapadia, S, Stortecky, S, Amat-Santos, I, Wijeysundera, HC, Lisko, J, Gutiérrez-Ibanes, E, Serra, V, Salido, L, Alkhodair, A, Livi, U, Chakravarty, T, Lerakis, S, Vilalta, V, Regueiro, A, Romaguera, R, Kappert, U, Barbanti, M, Masson, JB, Maes, F, Fiorina, C, Miceli, A, Kodali, S, Ribeiro, HB, Mangione, JA, De Brito, FS, Actis Dato, GM, Rosato, F, Ferreira, MC, de Lima, VC, Colafranceschi, AS, Abizaid, A, Marino, MA, Esteves, V, Andrea, J, Godinho, RR, Alfonso, F, Eltchaninoff, H, Søndergaard, L, Himbert, D, Husser, O, Latib, A, Le Breton, H, Servoz, C, Pascual, I, Siddiqui, S, Olivares, P, Hernandez-Antolin, R, Webb, JG, Sponga, S, Makkar, R, Kini, AS, Boukhris, M, Gervais, P, Linke, A, Crusius, L, Holzhey, D & Rodés-Cabau, J 2022, 'Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement', Clinical Infectious Diseases, vol. 75, no. 4, pp. 638-646. https://doi.org/10.1093/cid/ciab1004

@article{a0471453269c4d78841be8848f15dc72,

title = "Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement",

abstract = "Background. Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients. Methods. This multicenter study included 579 patients who had the diagnosis of definite IE at a median of 171 (53–421) days following TAVR. PEE was defined as the presence of an intracardiac abscess, pseudoaneurysm, or fistula. Results. A total of 105 patients (18.1%) were diagnosed with PEE (perivalvular abscess, pseudoaneurysm, fistula, or a combination in 87, 7, 7, and 4 patients, respectively). A history of chronic kidney disease (adjusted odds ratio [ORadj], 2.08; 95% confidence interval [CI]: 1.27–3.41; P = .003) and IE secondary to coagulase-negative staphylococci (ORadj, 2.71; 95% CI: 1.57–4.69; P < .001) were associated with an increased risk of PEE. Surgery was performed at index IE episode in 34 patients (32.4%) with PEE (vs 15.2% in patients without PEE, P < .001). In-hospital and 2-year mortality rates among PEE-IE patients were 36.5% and 69.4%, respectively. Factors independently associated with an increased mortality were the occurrence of other complications (stroke post-TAVR, acute renal failure, septic shock) and the lack of surgery at index IE hospitalization (padj < 0.05 for all). Conclusions. PEE occurred in about one-fifth of IE post-TAVR patients, with the presence of coagulase-negative staphylococci and chronic kidney disease determining an increased risk. Patients with PEE-IE exhibited high early and late mortality rates, and surgery during IE hospitalization seemed to be associated with better outcomes.",

keywords = "TAVI, TAVR, heart surgery, infective endocarditis",

author = "Vassili Panagides and {del Val}, David and Mohamed Abdel-Wahab and Norman Mangner and Eric Durand and Nikolaj Ihlemann and Marina Urena and Costanza Pellegrini and Francesco Giannini and Tomasz Gasior and Wojtek Wojakowski and Martin Landt and Vincent Auffret and Sinning, {Jan Malte} and Cheema, {Asim N.} and Luis Nombela-Franco and Chekrallah Chamandi and Francisco Campelo-Parada and Erika Munoz-Garcia and Herrmann, {Howard C.} and Luca Testa and Kim, {Won Keun} and Castillo, {Juan Carlos} and Alberto Alperi and Didier Tchetche and Bartorelli, {Antonio L.} and Samir Kapadia and Stefan Stortecky and Ignacio Amat-Santos and Wijeysundera, {Harindra C.} and John Lisko and Enrique Guti{\'e}rrez-Ibanes and Vicen{\c c} Serra and Luisa Salido and Abdullah Alkhodair and Ugolino Livi and Tarun Chakravarty and Stamatios Lerakis and Victoria Vilalta and Ander Regueiro and Rafael Romaguera and Utz Kappert and Marco Barbanti and Masson, {Jean Bernard} and Fr{\'e}d{\'e}ric Maes and Claudia Fiorina and Antonio Miceli and Susheel Kodali and Ribeiro, {Henrique B.} and Mangione, {Jose Armando} and {De Brito}, {Fabio Sandoli} and {Actis Dato}, {Guglielmo Mario} and Francesco Rosato and Ferreira, {Maria Cristina} and {de Lima}, {Valter Correia} and Colafranceschi, {Alexandre Siciliano} and Alexandre Abizaid and Marino, {Marcos Antonio} and Vinicius Esteves and Julio Andrea and Godinho, {Roger R.} and Fernando Alfonso and Helene Eltchaninoff and Lars S{\o}ndergaard and Dominique Himbert and Oliver Husser and Azeem Latib and {Le Breton}, Herv{\'e} and Clement Servoz and Isaac Pascual and Saif Siddiqui and Paolo Olivares and Rosana Hernandez-Antolin and Webb, {John G.} and Sandro Sponga and Raj Makkar and Kini, {Annapoorna S.} and Marouane Boukhris and Philippe Gervais and Axel Linke and Lisa Crusius and David Holzhey and Josep Rod{\'e}s-Cabau",

year = "2022",

month = aug,

day = "15",

doi = "10.1093/cid/ciab1004",

language = "English (US)",

volume = "75",

pages = "638--646",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "4",

}

TY - JOUR

T1 - Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement

AU - Panagides, Vassili

AU - del Val, David

AU - Abdel-Wahab, Mohamed

AU - Mangner, Norman

AU - Durand, Eric

AU - Ihlemann, Nikolaj

AU - Urena, Marina

AU - Pellegrini, Costanza

AU - Giannini, Francesco

AU - Gasior, Tomasz

AU - Wojakowski, Wojtek

AU - Landt, Martin

AU - Auffret, Vincent

AU - Sinning, Jan Malte

AU - Cheema, Asim N.

AU - Nombela-Franco, Luis

AU - Chamandi, Chekrallah

AU - Campelo-Parada, Francisco

AU - Munoz-Garcia, Erika

AU - Herrmann, Howard C.

AU - Testa, Luca

AU - Kim, Won Keun

AU - Castillo, Juan Carlos

AU - Alperi, Alberto

AU - Tchetche, Didier

AU - Bartorelli, Antonio L.

AU - Kapadia, Samir

AU - Stortecky, Stefan

AU - Amat-Santos, Ignacio

AU - Wijeysundera, Harindra C.

AU - Lisko, John

AU - Gutiérrez-Ibanes, Enrique

AU - Serra, Vicenç

AU - Salido, Luisa

AU - Alkhodair, Abdullah

AU - Livi, Ugolino

AU - Chakravarty, Tarun

AU - Lerakis, Stamatios

AU - Vilalta, Victoria

AU - Regueiro, Ander

AU - Romaguera, Rafael

AU - Kappert, Utz

AU - Barbanti, Marco

AU - Masson, Jean Bernard

AU - Maes, Frédéric

AU - Fiorina, Claudia

AU - Miceli, Antonio

AU - Kodali, Susheel

AU - Ribeiro, Henrique B.

AU - Mangione, Jose Armando

AU - De Brito, Fabio Sandoli

AU - Actis Dato, Guglielmo Mario

AU - Rosato, Francesco

AU - Ferreira, Maria Cristina

AU - de Lima, Valter Correia

AU - Colafranceschi, Alexandre Siciliano

AU - Abizaid, Alexandre

AU - Marino, Marcos Antonio

AU - Esteves, Vinicius

AU - Andrea, Julio

AU - Godinho, Roger R.

AU - Alfonso, Fernando

AU - Eltchaninoff, Helene

AU - Søndergaard, Lars

AU - Himbert, Dominique

AU - Husser, Oliver

AU - Latib, Azeem

AU - Le Breton, Hervé

AU - Servoz, Clement

AU - Pascual, Isaac

AU - Siddiqui, Saif

AU - Olivares, Paolo

AU - Hernandez-Antolin, Rosana

AU - Webb, John G.

AU - Sponga, Sandro

AU - Makkar, Raj

AU - Kini, Annapoorna S.

AU - Boukhris, Marouane

AU - Gervais, Philippe

AU - Linke, Axel

AU - Crusius, Lisa

AU - Holzhey, David

AU - Rodés-Cabau, Josep

PY - 2022/8/15

Y1 - 2022/8/15

N2 - Background. Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients. Methods. This multicenter study included 579 patients who had the diagnosis of definite IE at a median of 171 (53–421) days following TAVR. PEE was defined as the presence of an intracardiac abscess, pseudoaneurysm, or fistula. Results. A total of 105 patients (18.1%) were diagnosed with PEE (perivalvular abscess, pseudoaneurysm, fistula, or a combination in 87, 7, 7, and 4 patients, respectively). A history of chronic kidney disease (adjusted odds ratio [ORadj], 2.08; 95% confidence interval [CI]: 1.27–3.41; P = .003) and IE secondary to coagulase-negative staphylococci (ORadj, 2.71; 95% CI: 1.57–4.69; P < .001) were associated with an increased risk of PEE. Surgery was performed at index IE episode in 34 patients (32.4%) with PEE (vs 15.2% in patients without PEE, P < .001). In-hospital and 2-year mortality rates among PEE-IE patients were 36.5% and 69.4%, respectively. Factors independently associated with an increased mortality were the occurrence of other complications (stroke post-TAVR, acute renal failure, septic shock) and the lack of surgery at index IE hospitalization (padj < 0.05 for all). Conclusions. PEE occurred in about one-fifth of IE post-TAVR patients, with the presence of coagulase-negative staphylococci and chronic kidney disease determining an increased risk. Patients with PEE-IE exhibited high early and late mortality rates, and surgery during IE hospitalization seemed to be associated with better outcomes.

AB - Background. Infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) has been associated with a dismal prognosis. However, scarce data exist on IE perivalvular extension (PEE) in such patients. Methods. This multicenter study included 579 patients who had the diagnosis of definite IE at a median of 171 (53–421) days following TAVR. PEE was defined as the presence of an intracardiac abscess, pseudoaneurysm, or fistula. Results. A total of 105 patients (18.1%) were diagnosed with PEE (perivalvular abscess, pseudoaneurysm, fistula, or a combination in 87, 7, 7, and 4 patients, respectively). A history of chronic kidney disease (adjusted odds ratio [ORadj], 2.08; 95% confidence interval [CI]: 1.27–3.41; P = .003) and IE secondary to coagulase-negative staphylococci (ORadj, 2.71; 95% CI: 1.57–4.69; P < .001) were associated with an increased risk of PEE. Surgery was performed at index IE episode in 34 patients (32.4%) with PEE (vs 15.2% in patients without PEE, P < .001). In-hospital and 2-year mortality rates among PEE-IE patients were 36.5% and 69.4%, respectively. Factors independently associated with an increased mortality were the occurrence of other complications (stroke post-TAVR, acute renal failure, septic shock) and the lack of surgery at index IE hospitalization (padj < 0.05 for all). Conclusions. PEE occurred in about one-fifth of IE post-TAVR patients, with the presence of coagulase-negative staphylococci and chronic kidney disease determining an increased risk. Patients with PEE-IE exhibited high early and late mortality rates, and surgery during IE hospitalization seemed to be associated with better outcomes.

KW - TAVI

KW - TAVR

KW - heart surgery

KW - infective endocarditis

UR - http://www.scopus.com/inward/record.url?scp=85138128936&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85138128936&partnerID=8YFLogxK

U2 - 10.1093/cid/ciab1004

DO - 10.1093/cid/ciab1004

M3 - Article

C2 - 34894124

AN - SCOPUS:85138128936

SN - 1058-4838

VL - 75

SP - 638

EP - 646

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 4

ER -

Perivalvular Extension of Infective Endocarditis After Transcatheter Aortic Valve Replacement

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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