scholarly journals Predictors of Prosthetic Valve Endocarditis following Transcatheter Aortic Valve Replacement: A Meta-Analysis

2021 ◽  
Vol 24 (1) ◽  
pp. E101-E107
Author(s):  
Weiwei Jiang ◽  
Wenconghui Wu ◽  
Ruikang Guo ◽  
Minghui Xie ◽  
Wai Yen Yim ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Prosthetic Valve ◽  
Meta Analysis ◽  
Pacemaker Implantation ◽  
Prosthetic Valve Endocarditis ◽  
Orotracheal Intubation ◽  
Transcatheter Aortic Valve

Background: Transcatheter aortic valve replacement (TAVR) has gained increasing acceptance for patients with aortic disease. A rare but fatal complication prosthetic valve endocarditis (PVE) could greatly influence the clinical outcomes of TAVR. This meta-analysis aims to pin down the predictors of PVE in TAVR patients. Methods: We performed a systematic search for studies that reported the incidence and risk factors of PVE after TAVR. Data on studies, patients, baseline characteristics, and procedural characteristics were abstracted. Crude risk ratios (RRs) and 95% confidence intervals for each predictor were calculated by the use of random-effects models. Heterogeneity assumption was assessed by an I2 test. Results: We obtained data from 8 studies that included 68,805 TAVR patients, of whom 1,256 (1.83%) were diagnosed with PVE after TAVR. 280 patients died within the 30-days of PVE diagnosis and the pooled in-hospital mortality was 22.3%. The summary estimates indicated an increased risk of PVE after TAVR for males (RR 1.53, P = .0001); for patients with orotracheal intubation (RR 1.65, P = .01), new pacemaker implantation (RR 1.46, P = .003), and residual aortic regurgitation (≥2 grade) (RR 1.62, P = .05); while older age (RR 0.97, P = .0007) and implantation of a self-expandable valve (RR 0.74, P = .02) were associated with a lower risk of PVE after TAVR. Conclusion: Clinical characteristics and peri-procedure factors including age, male sex, valve type, orotracheal intubation, pacemaker implantation, and residual regurgitation were proven to be associated with the occurrence of PVE-TAVR. Clinicians should pay particular attention to PVE when treating TAVR patients with these predictors.

scholarly journals Prosthetic valve endocarditis after transcatheter aortic valve replacement: A case report and current review

2017 ◽  
Vol 4 (2) ◽  
pp. 10
Author(s):  
Tarek Chami ◽  
Guilherme Attizzani
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Transcatheter Aortic Valve ◽  
Current Review

Prosthetic valve endocarditis (PVE) after transcatheter aortic valve replacement (TAVR) is a rare but very serious and often deadly complication. Despite that, data are scarce and limited. Here, we report a case of a patient who developed PVE three months following TAVR and review the literature.

scholarly journals Incidence and outcome of prosthetic valve endocarditis after transcatheter aortic valve replacement in the Netherlands

2020 ◽  
Vol 28 (10) ◽  
pp. 520-525
Author(s):  
J. Brouwer ◽  
F. S. van den Brink ◽  
V. J. Nijenhuis ◽  
T. N. Vossenberg ◽  
R. Delewi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
The Netherlands ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
First Year ◽  
Transcatheter Aortic Valve

Abstract Background Transcatheter aortic valve replacement (TAVR) is increasingly being used as an alternative to conventional surgical valve replacement. Prosthetic valve endocarditis (PVE) is a rare but feared complication after TAVR, with reported first-year incidences varying from 0.57 to 3.1%. This study was performed to gain insight into the incidence and outcome of PVE after TAVR in the Netherlands. Methods A multicentre retrospective registry study was performed. All patients who underwent TAVR in the period 2010–2017 were screened for the diagnosis of infective endocarditis in the insurance database and checked for the presence of PVE before analysis of general characteristics, PVE parameters and outcome. Results A total of 3968 patients who underwent TAVR were screened for PVE. During a median follow-up of 33.5 months (interquartile range (IQR) 22.8–45.8), 16 patients suffered from PVE (0.4%), with a median time to onset of 177 days (IQR 67.8–721.3). First-year incidence was 0.24%, and the overall incidence rate was 0.14 events per 1000 person-years. Overall mortality during follow-up in our study was 31%, of which 25% occurred in hospital. All patients were treated conservatively with intravenous antibiotics alone, and none underwent a re-intervention. Other complications of PVE occurred in 5 patients (31%) and included aortic abscess (2), decompensated heart failure (2) and cerebral embolisation (1). Conclusion PVE in patients receiving TAVR is a relatively rare complication and has a high mortality rate.

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