Infective endocarditis after transcatheter aortic valve implantation: a nationwide study.
Eur Heart J
; 40(39): 3263-3269, 2019 10 14.
Article
en En
| MEDLINE
| ID: mdl-31433472
ABSTRACT
AIMS:
Transcatheter aortic valve implantation (TAVI), now a common procedure to treat high-risk patients with severe aortic stenosis, has rapidly been expanding into younger and lower-risk populations, creating a need to better understand long-term outcome after TAVI. The aim of the present investigation was to determine the incidence, risk factors for, clinical presentation of, and outcome after prosthetic valve endocarditis (PVE) in patients treated with TAVI in a nationwide study. METHODS ANDRESULTS:
Three registries were used a national TAVI registry, a national diagnosis registry, and a national infective endocarditis registry. Combining these registries made it possible to perform a nationwide, all-comers study with independent and validated reporting of PVE in 4336 patients between 2008 and mid-2018. The risk for PVE after TAVI was 1.4% (95% confidence interval 1.0-1.8%) the first year and 0.8% (0.6-1.1%) per year thereafter. One-year survival after PVE diagnosis was 58% (49-68%), and 5-year survival was 29% (17-41%). Body surface area, estimated glomerular filtration rate <30 mL/min/1.73 m2, critical pre-operative state, mean pre-procedural valve gradient, amount of contrast dye used, transapical access, and atrial fibrillation were identified as independent risk factors for PVE. Staphylococcus aureus was more common in early (<1 year) PVE. Infection with S. aureus, root abscess, late PVE, and non-community acquisition was associated with higher 6-month mortality.CONCLUSION:
The incidence of PVE was similar to that of surgical bioprostheses. Compromised renal function was a strong risk factor for developing PVE. In the context of PVE, TAVI seems to be a safe option for patients. CLINICAL TRIAL REGISTRATION NCT03768180 (http//clinicaltrials.gov/).Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Prótesis Valvulares Cardíacas
/
Infecciones Relacionadas con Prótesis
/
Endocarditis
/
Reemplazo de la Válvula Aórtica Transcatéter
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur Heart J
Año:
2019
Tipo del documento:
Article
País de afiliación:
Suecia