Abstract 19639: Infective Endocarditis Following Transcatheter Valve Implantation: A Systematic Review
Objectives: To describe the incidence, features, predisposing factors and outcomes of infective endocarditis (IE) following transcatheter valve implantation (TVI).
Background: Very few data exist on IE following TVI.
Methods: Studies published between 2000 and 2013 regarding IE in patients with aortic (TAVI) or pulmonary (TPVI) transcatheter valves were identified through systematic electronic search.
Result: A total of 28 publications describing 60 patients (32 TAVI, 28 TPVI) were identified. Most TAVI patients (66% males, 80±7 years) had a very high-risk profile (LogEuroSCORE: 30.4±14.0%, p<0.001 compared to previous TAVI registries). In TPVI patients (90% males, 19±6 years), IE was more frequent in stenotic conduit/valve (61%) (p <0.001 vs. previous TPVI series). Median time between TVI and IE was 5.5 (2-12) months. Typical microorganisms were mostly found with a higher incidence of enterococci after TAVI (34.4% vs. 0%, p =0.009), and S.aureus after TPVI (29.4% vs. 6.2%, p =0.041). Up to 60% of the TAVI-IE patients were managed medically despite related complications such as local extension, embolism and/or heart failure in >50% of patients. Valve explantation rate was 57% and 23% in balloon- and self-expandable valves, respectively (p=0.07). In-hospital mortality for TAVI-IE was 34.4%. Most TPVI-IE patients (75%) were managed surgically, and in-hospital mortality was 7.1%.
Conclusions: Most cases of IE post-TVI were males, with a very high-risk profile (TAVI) or underlying stenotic conduit/valve (TPVI). Typical -but different- microorganisms of IE were involved in half of the TAVI and TPVI cases. Most TPVI-IE patients were managed surgically as opposed to TAVI patients, and mortality rate was high in both cohorts.
Author Disclosures: I.J. Amat-Santos: Research Grant; Significant; Research contract from the Instituto de Salud Carlos III, Madrid Spain in the Institute of Heart Sciences of Valladolid, Spain. H.B. Ribeiro: None. M. Urena: None. R. Allende: None. C. Houde: None. E. Bedard: None. R. DeLarrochellière: None. J. Paradis: None. E. Dumont: None. D. Doyle: None. S. Mohammadi: None. M. Côté: None. J. Rodés-Cabau: Consultant/Advisory Board; Significant; Dr. Rodés-Cabau was consultant for Edward Lifesciences and St Jude Medical.
- © 2014 by American Heart Association, Inc.