Diagnosis of Infective Endocarditis After TAVR

Salaün, Erwan; Sportouch, Laura; Barral, Pierre-Antoine; Hubert, Sandrine; Lavoûte, Cécile; Casalta, Anne-Claire; Pradier, J.; Ouk, Daniel; Casalta, Jean‐Paul; Lambert, Marc; Gouriet, Frédérique; Gaubert, Jean-Yves; Dehaene, A.; Jacquier, Alexis; Tessonnier, L.; Haentjens, Julie; Théron, Alexis; Ribéri, Alberto; Cammilleri, Serge; Grisoli, Dominique; Jaussaud, Nicolas; Collart, Frédéric; Bonnet, J; Camoin, Laurence; Renard, Sébastien; Cuisset, Thomas; Avierinos, Jean-François; Lépidi, Hubert; Mundler, O.; Raoult, Didier; Habib, Gilbert

doi:10.1016/j.jcmg.2017.05.016

Cited by 70 publications

(17 citation statements)

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“…The lack of TOE findings in a large proportion of cases is probably explained by constraints of the stent frame on ultrasound performance. Alternative modalities such as ECG-gated computed tomography (CT) and positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG-PET/CT) provides additional diagnostic value in cases of PVE, but these procedures were not routinely performed or documented in our cohort 35 …”

Section: Discussionmentioning

confidence: 99%

Infective endocarditis after transcatheter aortic valve implantation: a nationwide study

Bjursten

Rasmussen

Nozohoor

et al. 2019

European Heart Journal

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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 and results 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/).

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Section: Discussionmentioning

confidence: 99%

Infective endocarditis after transcatheter aortic valve implantation: a nationwide study

Bjursten

Rasmussen

Nozohoor

et al. 2019

European Heart Journal

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“…That result means we cannot use echocardiography alone to rule out TAVR‐IE. Different echocardiographic patterns have recently been reported in TAVR‐IE, including an obstructive pattern with leaflet thickening and high transvalvular gradient 6. Data about echocardiography in TAVR‐IE, however, are still scarce and are based on registries or retrospective studies, which explains why the value of the Duke criteria7 in this population is unknown.…”

Section: Diagnosing Tavr Endocarditismentioning

confidence: 99%

“…In a recent series of 16 patients with suspected TAVR‐IE,6 it was found that the multi‐imaging approach (ESC criteria) had higher sensitivity than the Duke criteria (100% versus 50%, respectively) for the diagnosis of TAVR‐IE. Nevertheless, it was a single‐center study with a relatively small cohort, and the results obtained should be interpreted with caution 6…”

Section: Diagnosing Tavr Endocarditismentioning

confidence: 99%

Infective Endocarditis After Transcatheter Aortic Valve Replacement: The Worst That Can Happen

Habib

2018

JAHA

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“…Durch den perivalvulären Kalk und das Klappengerüst (Stent) ist in der echokardiografischen Diagnostikeinschließlich der TEE die Klappe oft überlagert von Auslöschungsartefakten und Reflexionen. Bei der TAVI-IE findet sich häufiger ein obstruktiver Typ als bei nativen Klappen [21].…”

Section: Endokarditis Nach Taviunclassified