학술논문
Infective Endocarditis Following Transcatheter Aortic Valve Replacement: Comparison of Balloon- Versus Self-Expandable Valves.
Document Type
Academic Journal
Author
Regueiro A; Quebec Heart & Lung Institute, Laval University, Quebec City, Canada; Linke; Heart Center, Leipzig University, Germany; Latib; Interventional Cardiology Unit, Ospedale San Raffaele, Milan, Italy; Ihlemann; Righospitalet, Copenhagen, Denmark; Urena; Bichat Hôpital, Paris, France; Walther; Kerckhoff Klinik, Nauheim, Germany; Husser; Deutsches Herzzentrum, München, Germany; Herrmann C; Hospital of the University of Pennsylvania, Philadelphia; Nombela-Franco; Cardiovascular Institute, Hospital Universitario Clinico San Carlos, Madrid, Spain; Cheema; Division of Cardiology, St. Michaels Hospital, Toronto, Canada; Le Breton H; Centre Hospitalier Universitaire de Rennes, France; Stortecky; Bern University Hospital (on behalf of Swiss Registry Centres), Switzerland; Kapadia; Cleveland Clinic; Bartorelli L; Centro Cardiologico Monzino, Milan, Italy; Sinning; Heart Center Bonn, Germany; Amat-Santos; Hospital Clinico Universitario de Valladolid, Spain; Munoz-Garcia J; Department of Cardiology, Hospital Universitario Virgen de la Victoria, Malaga, Spain; Lerakis; Emory University School of Medicine, Atlanta; Gutíerrez-Ibanes; Department of Cardiology, Instituto de Investigación Sanitaria Gregorio Marañon, Hospital Gregorio Maranon, Madrid, Spain; Abdel-Wahab; Heart Center, Bad Segeberg, Germany; Tchetche; Clinique Pasteur, Toulouse, France; Testa; IRCCS Pol. San Donato, Milan, Italy; Eltchaninoff; Hôpital Charles Nicolle, University of Rouen, France; Livi; AOU Santa Maria della Misericordia, Udine, Italy; Castillo; Department of Cardiology, Hospital Universitario Reina Sofia, Cordoba, Spain; Jilaihawi; Cedars-Sinai Heart Institute, Los Angeles; Webb G; Center for Heart Valve Innovation, St. Pauls Hospital, Vancouver, Canada; Barbanti M; Ferrarotto Hospital, Catania, Italy; Kodali; Columbia University Medical Center, New York; de Brito Jr S; Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Ribeiro B; Instituto Nacional Cardiovascular (INCOR), Sao Paulo, Brazil; Miceli; Fondazione Toscana G. Monasterio, Massa, Italy; Fiorina; Ospedali Civili di Brescia, Italy; Actis Dato; Ospedali Mauriziano, Torino, Italy; Rosato F; S. Cocre e Carle Cuneo, Italy; Serra; Hospital Vall d’Hebron, Barcelona, Spain; Masson; Centre Hospitalier de l’Universite de Montreal, Canada; Wijeysundera C; Sunnybrook Health Science Center, Toronto, Canada; Mangione A; Hospital Beneficencia Portuguesa, Sao Paulo, Brazil; Ferreira; Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil; Lima C; Hospital Sao FranciscoSanta Clara, Porto Alegre, Brazil; Carvalho A; Hospital Pró-cardíaco, Rio de Janeiro, Brazil; Abizaid; Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil; Marino A; Hospital Madre Teresa, Belo Horizonte, Brazil; Esteves; Hospital Sao Luiz, Sao Paulo, Brazil; Andrea C.M.; Clínica Sao Vicente, Rio de Janeiro, Brazil; Messika-Zeitoun; Bichat Hôpital, Paris, France; Himbert; Bichat Hôpital, Paris, France; Kim; Kerckhoff Klinik, Nauheim, Germany; Pellegrini; Deutsches Herzzentrum, München, Germany; Auffret; Centre Hospitalier Universitaire de Rennes, France; Nietlispach; University Hospital Zurich, Switzerland; Pilgrim; Bern University Hospital (on behalf of Swiss Registry Centres), Switzerland; Durand; Hôpital Charles Nicolle, University of Rouen, France; Lisko; Emory University School of Medicine, Atlanta; Makkar R; Cedars-Sinai Heart Institute, Los Angeles; Lemos; Instituto Nacional Cardiovascular (INCOR), Sao Paulo, Brazil; Leon B; Columbia University Medical Center, New York; Puri; Quebec Heart & Lung Institute, Laval University, Quebec City, Canada; San Roman; Hospital Clinico Universitario de Valladolid, Spain; Vahanian; Bichat Hôpital, Paris, France; Søndergaard; Righospitalet, Copenhagen, Denmark; Mangner; Heart Center, Leipzig University, Germany; Rodés-Cabau; Quebec Heart & Lung Institute, Laval University, Quebec City, Canada
Source
Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101499602 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1941-7632 (Electronic) Linking ISSN: 19417640 NLM ISO Abbreviation: Circ Cardiovasc Interv Subsets: MEDLINE
Subject
Language
English
Abstract
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.
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.