TY - JOUR
T1 - Infective Endocarditis After Transcatheter versus Surgical Aortic Valve Replacement
AU - Panagides, Vassili
AU - Cuervo, Guillermo
AU - Llopis, Jaume
AU - Abdel-Wahab, Mohamed
AU - Mangner, Norman
AU - Habib, Gilbert
AU - Regueiro, Ander
AU - Mestres, Carlos
AU - Tornos, Pilar
AU - Durand, Eric
AU - Selton-Suty, Christine
AU - Ihlemann, Nikolaj
AU - Bruun, Niels
AU - Urena, Marina
AU - Cecchi, Enrico
AU - Thiele, Holger
AU - Durante-Mangoni, Emanuele
AU - Pellegrini, Costanza
AU - Eltchaninoff, Helene
AU - Athan, Eugene
AU - Søndergaard, Lars
AU - Linke, Axel
AU - Tattevin, Pierre
AU - Del Val, David
AU - Quintana, Eduard
AU - Chu, Vivian
AU - Rodés-Cabau, Josep
AU - Miro, Jose M
N1 - © 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].
PY - 2024/1/25
Y1 - 2024/1/25
N2 - 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.
AB - 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.
KW - Aortic Valve Stenosis/etiology
KW - Aortic Valve/surgery
KW - Endocarditis, Bacterial/epidemiology
KW - Endocarditis/epidemiology
KW - Heart Valve Prosthesis Implantation/adverse effects
KW - Heart Valve Prosthesis/adverse effects
KW - Humans
KW - Risk Factors
KW - Treatment Outcome
U2 - 10.1093/cid/ciad464
DO - 10.1093/cid/ciad464
M3 - Article
C2 - 37552784
SN - 1058-4838
VL - 78
SP - 179
EP - 187
JO - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
IS - 1
ER -