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

Brouwer, Jorn; Brink, F. van den; Nijenhuis, Vincent J.; Vossenberg, Tessel N.E.; Delewi, Ronak; Mourik, Martijn S. van; Heijer, Peter den; Tanis, Wilco; Kievit, Peter C.; Holvoet, Wouter; Hermanides, R. S.; Berg, Jürrien M. ten

doi:10.1007/s12471-020-01420-2

Cited by 10 publications

(8 citation statements)

References 28 publications

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“…There are three studies reporting onset of IE at 6 months after TAVR [13][14][15], whereas Butt et al seem to refute this, citing a median of 12 months for rehospitalization due to IE [10]. In our study, IE-related prosthetic failures were explanted 368 days after prior TAVR.…”

Section: Infective Endocarditis (Ie)mentioning

confidence: 66%

“…Reguiero et al were focused on post-TAVR IE in their analysis of 245 patients, finding no difference in early or late mortality or reoperation rate by prosthesis type (BEV vs SEV) [ 13 ]. On the other hand, Mylotte et al [ 6 ] and Amat-Santos et al have separately recorded higher rates of post-TAVR IE for BEV (vs SEV) implants (59% vs 41%, and 64% vs 36%, respectively), with the reverse being documented by Brouwer et al (SEV, 56%; BEV, 44%) [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

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Surgical explantation of failed transcatheter heart valves: indications and results

et al. 2022

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Given the recent surge in transcatheter heart valve replacement (THVR), cardiac surgeons will surely face the challenge of eventual explantation. The aim of this study was to determine indications for reoperation, while exploring pertinent technical aspects and survival after THV explantation in a cohort originally deemed high risk or even inoperable. Between February 2008 and March 2019, 31 patients with failed transcatheter aortic valve replacement (TAVR) underwent surgical explantations at our facility. Data were prospectively collected for retrospective analysis of procedural indications, technical issues, and postoperative survival. The major reason for TAVR removal was bioprosthetic valve failure (BVF) due to infective endocarditis (IE: 16/31 [51.6%]), non-structural (NSVD: 14/31 [45.2%]) and structural (SVD: 1/31 [3.2%]) valve deterioration accounting for the rest. Mean age at THV explantation was 76.3 ± 8.3 years, and median time from TAVR to explantation was 153 days (0 days–56.6 months). Median ICU and hospital stay were 6 days (1–44 days) and 23 days (8–62 days), respectively. Thirty-day and 1-year survival rates were 74.2% and 67.2%, respectively. Median follow-up interval after explantation was 364 days (3 days–80 months). Mean cardiopulmonary bypass time was 124.6 ± 46.8 min, and mean aortic cross-clamp time was 84.3 ± 32.9 min. There was no need for unplanned aortic root repair owing to tissue damage during dissection of the TAVR from surrounding tissue. The most common reason for THV explantation was (a) BVF for IE and (b) BVF secondary to NSVD. Although 30-day and 1-year mortality rates in this multimorbid cohort were predictably high, no procedural mortalities occurred.

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Section: Infective Endocarditis (Ie)mentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Surgical explantation of failed transcatheter heart valves: indications and results

et al. 2022

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“…2 TAVR-IE is not well defined in the literature with data derived mainly from single-center observational experiences or pooled analysis from trials and registries. [3][4][5] A recent study reported similar temporal incidence and risk of IE between TAVR (5.21 cases per 1000 person-years) and surgical aortic valve replacement (SAVR) (4.10 cases per 1000 person-years; p ¼ 0.44), occurring mainly between 31 days and 1 year. 3 Prosthetic valve endocarditis either due to TAVR-IE or SAVR-IE was associated with more than 4-fold increased risk of death in this large cohort study.…”

Section: Introductionmentioning

confidence: 92%

Transcatheter Aortic Valve Replacement–Associated Infective Endocarditis: Comparison of Early, Intermediate, and Late-Onset Cases

et al. 2022

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“…In our cohort, we observed a few differences in the preoperative-risk profile of the patients that may influence the decision-making process and partly explain the reluctance toward surgery [ 5 , 7 ]. Age is a crucial factor which plays a role in the decision-making process.…”

Section: Commentmentioning

confidence: 99%

“…Although current guidelines consider surgery to be the best option in cases of prosthetic valve endocarditis (PVE), the current literature reports a general reluctance toward the surgical treatment of IE following transcatheter aortic valve implantation (TIE), with some patients entering palliative care upon diagnosis [ 1 , 2 , 3 , 4 , 5 ]. Infective endocarditis (IE) is the leading cause of reoperation following transcatheter aortic valve replacement [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Surgery for Aortic Prosthetic Valve Endocarditis in the Transcatheter Era

Saha

Ali

Schnackenburg

et al. 2022

JCM

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Objectives: As surgical experience with infective endocarditis following transcatheter aortic valve replacement is scarce, this study compared the perioperative and short-term outcomes of patients suffering from endocarditis following surgical aortic valve replacement and transcatheter aortic valve replacement. Methods: Between January 2013 and December 2020, 468 consecutive patients were admitted to our center for surgery for IE. Among them, 98 were operated on for endocarditis following surgical aortic valve replacement and 22 for endocarditis following transcatheter aortic valve replacement. Results: The median EuroSCORE II (52.1 (40.6–62.0) v/s 45.4 (32.6–58.1), p = 0.207) and STS-PROM (1.8 (1.6–2.1) v/s 1.9 (1.4–2.2), p = 0.622) were comparable. Endocarditis following transcatheter aortic valve replacement accounted for 13.7% of the aortic prosthetic valve endocarditis between 2013 and 2015; this increased to 26.9% in the years 2019 and 2020. Concomitant procedures were performed in 35 patients (29.2%). The operative mortality was 26.5% in the endocarditis following surgical aortic valve replacement group and 9.1% in the endocarditis following transcatheter aortic valve replacement group (p = 0.098). Upon follow-up, survival at 6 months was found to be 98% in the group with endocarditis following surgical aortic valve replacement and 89% in the group with endocarditis following transcatheter aortic valve replacement (p = 0.081). Conclusions: Patients suffering from endocarditis following surgical aortic valve replacement and transcatheter aortic valve replacement present with comparable risk profiles and can be surgically treated with comparable results. Surgery as a curative option should not be rejected even in this intermediate-risk cohort.

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

Cited by 10 publications

References 28 publications

Surgical explantation of failed transcatheter heart valves: indications and results

Surgical explantation of failed transcatheter heart valves: indications and results

Transcatheter Aortic Valve Replacement–Associated Infective Endocarditis: Comparison of Early, Intermediate, and Late-Onset Cases

Surgery for Aortic Prosthetic Valve Endocarditis in the Transcatheter Era

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