Infective Endocarditis After Transcatheter versus Surgical Aortic Valve Replacement

Vassili Panagides, Guillermo Cuervo, Jaume Llopis, Mohamed Abdel-Wahab, Norman Mangner, Gilbert Habib, Ander Regueiro, Carlos Mestres, Pilar Tornos, Eric Durand, Christine Selton-Suty, Nikolaj Ihlemann, Niels Bruun, Marina Urena, Enrico Cecchi, Holger Thiele, Emanuele Durante-Mangoni, Costanza Pellegrini, Helene Eltchaninoff, Eugene AthanLars Søndergaard, Axel Linke, Pierre Tattevin, David Del Val, Eduard Quintana, Vivian Chu, Josep Rodés-Cabau*, Jose M Miro*

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

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.

OriginalsprogEngelsk
Sider (fra-til)179-187
Antal sider9
TidsskriftClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Vol/bind78
Udgave nummer1
Tidlig onlinedato8 aug. 2023
DOI
StatusUdgivet - 25 jan. 2024

Bibliografisk note

© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: [email protected].

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