TY - JOUR
T1 - Very early infective endocarditis after transcatheter aortic valve replacement
AU - Panagides, Vassili
AU - Abdel-Wahab, Mohamed
AU - Mangner, Norman
AU - Durand, Eric
AU - Ihlemann, Nikolaj
AU - Urena, Marina
AU - Pellegrini, Costanza
AU - Giannini, Francesco
AU - Scislo, Piotr
AU - Huczek, Zenon
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 - Eltchaninoff, Helene
AU - Søndergaard, Lars
AU - Himbert, Dominique
AU - Husser, Oliver
AU - Latib, Azeem
AU - Le Breton, Hervé
AU - Servoz, Clement
AU - Gervais, Philippe
AU - del Val, David
AU - Linke, Axel
AU - Crusius, Lisa
AU - Thiele, Holger
AU - Holzhey, David
AU - Rodés-Cabau, Josep
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
PY - 2022/10
Y1 - 2022/10
N2 - Background: Scarce data exist about early infective endocarditis (IE) after trans-catheter aortic valve replacement (TAVR). Objective: The objective was to evaluate the characteristics, management, and outcomes of very early (VE) IE (≤ 30 days) after TAVR. Methods: This multicenter study included a total of 579 patients from the Infectious Endocarditis after TAVR International Registry who had the diagnosis of definite IE following TAVR. Results: Ninety-one patients (15.7%) had VE-IE. Factors associated with VE-IE (vs. delayed IE (D-IE)) were female gender (p = 0.047), the use of self-expanding valves (p < 0.001), stroke (p = 0.019), and sepsis (p < 0.001) after TAVR. Staphylococcus aureus was the main pathogen among VE-IE patients (35.2% vs. 22.7% in the D-IE group, p = 0.012), and 31.2% of Staphylococcus aureus infections in the VE-IE group were methicillin-resistant (vs. 14.3% in the D-IE group, p = 0.001). The second-most common germ was enterococci (34.1% vs. 24.4% in D-IE cases, p = 0.05). VE-IE was associated with very high in-hospital (44%) and 1-year (54%) mortality rates. Acute renal failure following TAVR (p = 0.001) and the presence of a non-enterococci pathogen (p < 0.001) were associated with an increased risk of death. Conclusion: A significant proportion of IE episodes following TAVR occurs within a few weeks following the procedure and are associated with dismal outcomes. Some baseline and TAVR procedural factors were associated with VE-IE, and Staphylococcus aureus and enterococci were the main causative pathogens. These results may help to select the more appropriate antibiotic prophylaxis in TAVR procedures and guide the initial antibiotic therapy in those cases with a clinical suspicion of IE. Graphical abstract: Very early infective endocarditis after trans-catheter aortic valve replacement. VE-IE indicates very early infective endocarditis (≤30 days post TAVR). D-IE indicates delayed infective endocarditis. [Figure not available: see fulltext.].
AB - Background: Scarce data exist about early infective endocarditis (IE) after trans-catheter aortic valve replacement (TAVR). Objective: The objective was to evaluate the characteristics, management, and outcomes of very early (VE) IE (≤ 30 days) after TAVR. Methods: This multicenter study included a total of 579 patients from the Infectious Endocarditis after TAVR International Registry who had the diagnosis of definite IE following TAVR. Results: Ninety-one patients (15.7%) had VE-IE. Factors associated with VE-IE (vs. delayed IE (D-IE)) were female gender (p = 0.047), the use of self-expanding valves (p < 0.001), stroke (p = 0.019), and sepsis (p < 0.001) after TAVR. Staphylococcus aureus was the main pathogen among VE-IE patients (35.2% vs. 22.7% in the D-IE group, p = 0.012), and 31.2% of Staphylococcus aureus infections in the VE-IE group were methicillin-resistant (vs. 14.3% in the D-IE group, p = 0.001). The second-most common germ was enterococci (34.1% vs. 24.4% in D-IE cases, p = 0.05). VE-IE was associated with very high in-hospital (44%) and 1-year (54%) mortality rates. Acute renal failure following TAVR (p = 0.001) and the presence of a non-enterococci pathogen (p < 0.001) were associated with an increased risk of death. Conclusion: A significant proportion of IE episodes following TAVR occurs within a few weeks following the procedure and are associated with dismal outcomes. Some baseline and TAVR procedural factors were associated with VE-IE, and Staphylococcus aureus and enterococci were the main causative pathogens. These results may help to select the more appropriate antibiotic prophylaxis in TAVR procedures and guide the initial antibiotic therapy in those cases with a clinical suspicion of IE. Graphical abstract: Very early infective endocarditis after trans-catheter aortic valve replacement. VE-IE indicates very early infective endocarditis (≤30 days post TAVR). D-IE indicates delayed infective endocarditis. [Figure not available: see fulltext.].
KW - Anti-bio-prophylaxis
KW - Healthcare-associated infection
KW - Heart surgery
KW - Infective endocarditis
KW - TAVR
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U2 - 10.1007/s00392-022-01998-0
DO - 10.1007/s00392-022-01998-0
M3 - Article
C2 - 35262756
AN - SCOPUS:85128495977
SN - 1861-0684
VL - 111
SP - 1087
EP - 1097
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
IS - 10
ER -