Infective endocarditis after transcatheter versus surgical aortic valve replacement

Abstract Background Scarce data are available comparing infective endocarditis (IE) following surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). This study aimed to compare the clinical presentation, microbiological profile, management, and outcomes of IE aft...

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Detalles Bibliográficos
Autores: Panagides, Vassili, Cuervo Requena, Guillermo, Llopis Pérez, Jaime, Abdel-wahab, Mohamed, Mangner, Norman, Habib, Gilbert, Regueiro, Ander, Mestres, Carlos A., Tornos, Pilar, Durand, Eric, Selton Suty, Christine, Ihlemann, Nikolaj, Bruun, Niels E, Urena, Marina, Cecchi, Enrico, Thiele, Holger, Durante Mangoni, E., Pellegrini, Costanza, Eltchaninoff, Helene, Athan, Eugene, Søndergaard, Lars, Linke, Axel, Tattevin, Pierre, Val, David del, Quintana, Eduard, Chu, Vivian, Rodés Cabau, Josep, Miró Meda, José M. (José María), 1956-, TAVI Infective Endocarditis International Registry and ICE Investigators
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/227363
Acceso en línea:https://hdl.handle.net/2445/227363
Access Level:acceso abierto
Palabra clave:Endocarditis
Pròtesis valvulars cardíaques
Cirurgia cardiovascular
Heart valve prosthesis
Cardiovascular surgery
Descripción
Sumario:Abstract Background Scarce data are available comparing infective endocarditis (IE) following surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). This study aimed to compare the clinical presentation, microbiological profile, management, and outcomes of IE after SAVR versus TAVR. Methods Data were collected from the “Infectious Endocarditis after TAVR International” (enrollment from 2005 to 2020) and the “International Collaboration on Endocarditis” (enrollment from 2000 to 2012) registries. Only patients with an IE affecting the aortic valve prosthesis were included. A 1:1 paired matching approach was used to compare patients with TAVR and SAVR. Results A total of 1688 patients were included. Of them, 602 (35.7%) had a surgical bioprosthesis (SB), 666 (39.5%) a mechanical prosthesis, 70 (4.2%) a homograft, and 350 (20.7%) a transcatheter heart valve. In the SAVR versus TAVR matched population, the rate of new moderate or severe aortic regurgitation was higher in the SB group (43.4% vs 13.5%; P < .001), and fewer vegetations were diagnosed in the SB group (62.5% vs 82%; P < .001). Patients with an SB had a higher rate of perivalvular extension (47.9% vs 27%; P < .001) and Staphylococcus aureus was less common in this group (13.4% vs 22%; P = .033). Despite a higher rate of surgery in patients with SB (44.4% vs 27.3%; P < .001), 1-year mortality was similar (SB: 46.5%; TAVR: 44.8%; log-rank P = .697). Conclusions Clinical presentation, type of causative microorganism, and treatment differed between patients with an IE located on SB compared with TAVR. Despite these differences, both groups exhibited high and similar mortality at 1-year follow-up.

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