Incidence, Predictors, and Outcome of Patients Developing Infective Endocarditis Following Transfemoral Transcatheter Aortic Valve Replacement

Cardiac Surgery Compared With Antibiotics Only in Patients Developing Infective Endocarditis After Transcatheter Aortic Valve Replacement

“…In this analysis, selected patients with echocardiographic evidence of IE were considered for CS in about one third of all cases, which is somewhat higher than in other studies in the field 3, 7. However, compared with 72% of patients having at least 1 indication for surgery, according to current guidelines,9 the rate of CS performed in this cohort is still low.…”

“…Infective endocarditis (IE) after transcatheter aortic valve replacement (TAVR) occurs in 0.67% to 3.4% of patients per patient year 1, 2, 3, 4, 5, 6, 7. According to a recent multicenter registry, it is associated with an in‐hospital mortality of 41.8% and a 2‐year mortality rate of 66.7%,7 which is ≈2‐fold higher compared with contemporary surgical cohorts with prosthetic valve endocarditis (PVE) 8.…”

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

“…Contrary to their previous paper, in which 31.9% patients with TAVR‐IE had negative imaging studies,2 the authors included in the current study5 only patients with echocardiographic evidence of IE. Forty‐one patients with definite or possible TAVR‐IE were thus excluded from the study because of the absence of echocardiographic evidence of IE 5.…”

“…Usual echocardiographic criteria are not easily applicable in TAVR‐IE. A previous series from Mangner et al, for example, included 55 patients with TAVR‐IE, among whom transesophageal echocardiography was performed in 47 (85%), vegetation was observed on the prosthesis in only 12 (25%), and imaging was negative in 15/47 (31.9%) 2. That result means we cannot use echocardiography alone to rule out TAVR‐IE.…”

“…Infective endocarditis (IE) is a recently described complication of TAVR that is difficult to diagnosis and has a dismal prognosis; TAVR‐IE deserves prompt diagnosis and treatment 2, 3, 4. However, relatively few data exist concerning TAVR‐IE and the best way to manage these patients, particularly concerning the benefit of early surgery.…”