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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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

TidsskriftCirculation. Cardiovascular interventions
Udgave nummer11
Sider (fra-til)e007938
StatusUdgivet - 2019

ID: 59017914