Infective endocarditis following transcatheter aortic valve replacement: comparison of balloon- versus self-expandable valves
Circ. cardiovasc. interv
; 12(11): 1-8, nov., 2019. ilus., graf., tab.
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1049984
Biblioteca responsável:
BR79.1
Localização: BR79.1
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. (AU)
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Sistema de Registros
/
Incidência
/
Endocardite
/
Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Ensaio clínico controlado
/
Estudo de incidência
/
Estudo prognóstico
Idioma:
Inglês
Revista:
Circ. cardiovasc. interv
Ano de publicação:
2019
Tipo de documento:
Artigo
Instituição/País de afiliação:
AOU Santa Maria della Misericordia/IT
/
Bern University Hospital (on behalf of Swiss Registry Centres)/CH
/
Bichat Hôpital/FR
/
Cedars-Sinai Heart Institute/US
/
Centre Hospitalier Universitaire de Rennes/FR
/
Centre Hospitalier de l'Universite de Montreal/CA
/
Centro Cardiologico Monzino/IT
/
Cleveland Clinic/US
/
Clinique Pasteur/FR
/
Clínica Sao Vicente/BR