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

Habib, Gilbert

doi:10.1161/jaha.118.010287

Cited by 20 publications

(24 citation statements)

References 16 publications

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“…Use of antibiotic prophylaxis must rely on local resistance patterns covering the most typical microbial aetiologies of TAVI-IE and short-term prophylaxis (1 day) should be preferred. In this regard, for patients with THV, preventive strategies should focus on good sanitary conditions including cutaneous care, good oral hygiene, good care of dialysis catheters and well-balanced hyperglycaemic treatment for diabetes mellitus [10,18,59].…”

Section: Prevention Of Tavi-ie During and After The Proceduresmentioning

confidence: 99%

“…Patients with TAVI-IE have a large burden of comorbidities and management of these patients is highly difficult [18,68]. Most of the TAVI-IE patients presented in the observational studies included in this review were reported to have an indication for surgical intervention (50.0% or more) according to guidelines (embolism, valve failure leading to heart failure, uncontrolled infection) [10,49]; however, only a small subset of patients underwent surgery (16.4% or less) (Table 3) [20,21,23,25].…”

Section: Managementmentioning

confidence: 99%

“…Further, patients with TAVI-IE are often elderly, with a high burden of comorbidities and this patient group are therefore rarely candidates for surgical treatment. Management and optimal treatment of the patient group are challenged by this [18]. In addition, details on diagnosis, characterization of microbiological aetiologies and detailed antimicrobial treatments are only sparsely reported.…”

Section: Introductionmentioning

confidence: 99%

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Infective endocarditis in patients who have undergone transcatheter aortic valve implantation: a review

Østergaard

Lauridsen

Iversen

et al. 2020

Clinical Microbiology and Infection

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Background: Transcatheter aortic valve implantation (TAVI) has been approved for the treatment of severe aortic stenosis since 2008 and recent trials have shown that TAVI is at least non-inferior to surgical aortic valve replacement (SAVR) with regards to short-term efficacy and safety in patients across all surgical risk profiles. Prosthetic valve endocarditis of the transcatheter heart valve is a feared complication; data on the risk of infective endocarditis (IE) subsequent to TAVI are now gradually emerging. Objectives: We set forth to conduct a review of the incidence, diagnosis, microbial aetiologies, prevention, outcome and management of TAVI-IE. Sources: From the MEDLINE database we included a total of 12 observational studies and five studies of long-term results from randomized controlled trials. Content: The incidence of TAVI-IE was reported to be between 0.7% and 3.0% per person-year. The most common microbes were reported to be enterococci, Staphylococcus aureus, streptococci and coagulasenegative staphylococci. International guidelines on prevention strategies of IE recommend good sanitary conditions including cutaneous care, good oral hygiene and good care of dialysis catheters. Antibiotic prophylaxis is recommended by guidelines prior to dental procedures in patients with TAVI; however, evidence is sparse. The majority of the patients included in this review with TAVI-IE had an indication for surgical intervention due to IE (50.0% or more); however, only a small subset of the patients underwent surgery (16.4% or less). The in-hospital mortality was around 25%, i.e. of the same order of magnitude as in prosthetic valve IE in general, but varied substantially between studies (from 11% to 64%). Implications: The US Food and Drug Administration's approval of TAVI in patients at low surgical risk may change the characteristics of patients with TAVI, which may influence the incidence, management, and outcome of patients with TAVI-IE.

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Section: Prevention Of Tavi-ie During and After The Proceduresmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Infective endocarditis in patients who have undergone transcatheter aortic valve implantation: a review

Østergaard

Lauridsen

Iversen

et al. 2020

Clinical Microbiology and Infection

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“…According to guidelines, early surgery is indicated in complicated cases of post-TAVI IE. Because these patients are high-risk, surgery is contraindicated in most of the patients with post-TAVI IE [31]. https://doi.org/10.1371/journal.pone.0225077.g001 "The JenaValve transcatheter heart valve (THV) prosthesis (JenaValve Technology GmbH, Munich, Germany), a trileaflet porcine root tissue valve attached to a nitinol stent (A) and its implantation in illustration (B to D) and fluoroscopy (E to H).…”

Section: Introductionmentioning

confidence: 99%

Infective endocarditis post-transcatheter aortic valve implantation (TAVI), microbiological profile and clinical outcomes: A systematic review

et al. 2020

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Background The data on infective endocarditis after transcatheter aortic valve implantation (TAVI) is scarce and limited to case reports and case series in the literature. It is the need of the hour to analyze the available data on post-TAVI infective endocarditis from the available literature. The objectives of this systematic review were to evaluate the incidence of infective endocarditis after transcatheter aortic valve implantation, its microbiological profile and clinical outcomes. It will help us to improve the antibiotic prophylaxis strategies and treatment options for infective endocarditis in the context of TAVI. Methods EMBASE, Medline and the CENTRAL trials registry of the Cochrane Collaboration were searched for articles on infective endocarditis in post-TAVI patients till October 2018. Eleven articles were included in the systematic review. The outcomes assessed werethe incidence of infective endocarditis, its microbiological profile andclinical outcomes including major adverse cardiac event (MACE), net adverse clinical event (NACE), surgical intervention and valve-in-valve procedure. Results The incidence of infective endocarditis varied from 0%-14.3% in the included studies, the mean was3.25%. The average duration of follow-up was 474 days (1.3 years). Enterococci were the most common causative organism isolated from 25.9% of cases followed by Staphylococcus aureus (16.1%) and coagulase-negative Staphylococcus species (14.7%). The mean in-hospital mortality and mortality at follow-up was 29.5% and 29.9%, respectively. The cumulative incidence of heart failure, stroke and major bleeding were 37.1%, 5.3% and 11.3%,respectively. Only a single study by Martinez-Selles et al. reported arrhythmias in 20% cases. The septic shock occurred in 10% and 27.7% post-TAVI infective

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“…Use of CT imaging for detection of para-valvular lesions and use of [18] FDG PET/ SPECT for PVE is now considered as a major criterion in 2015 ESC guidelines [36]. The use of FDG PET/ SPECT has increased the sensitivity of the Duke criteria without affecting specificity [18,37,38].…”

Section: Diagnosismentioning

confidence: 99%

Submitral Aneurysm Secondary to Infective Endocarditis: Review of Literature and Case Report

Shakapur¹,

Honnalli²,

Mali³

2019

Angiol Open Access

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Submitral aneurysm is seldom reported worldwide. It is thought to be caused by weakness in the cardiac musculature due to abnormal embryogenesis. Mostly these aneurysms were reported from Africa in black African population. Apart from congenital cause, many other causes have been put forth as its etiology. Among these endocarditis is a known infective etiology. Submitral aneurysm secondary to left sided infective endocarditis is rare. The definitive diagnostic modality and treatment of submitral aneurysm remains echocardiography and surgical correction of aneurysm respectively. The submitral aneurysms as well as infective endocarditis both are known independent risk factors for thromboembolic events and subsequent stroke increasing both morbidity and mortality.The management of submitral aneurysm includes surgical correction by repair of the aneurysm but it requires careful consideration of surgical resection of diseased paravalvular tissue or diseased mitral valve and correction of mitral regurgitation by preforming mitral valve replacement. The surgical approach reduces the risk of recurrent endocarditis and thromboembolic events, thus reducing the risk of stroke. Prior to surgery, patient should receive prophylactic antibiotics for one to two weeks to control any active infective endocarditis. For us successful treatment of a patient suffering from submitral aneurysm due to infective endocarditis was challenging. We are reporting a case of submitral aneurysm secondary to infective endocarditis along with review of literature on infective endocarditis and submitral aneurysm.

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

Cited by 20 publications

References 16 publications

Infective endocarditis in patients who have undergone transcatheter aortic valve implantation: a review

Infective endocarditis in patients who have undergone transcatheter aortic valve implantation: a review

Infective endocarditis post-transcatheter aortic valve implantation (TAVI), microbiological profile and clinical outcomes: A systematic review

Submitral Aneurysm Secondary to Infective Endocarditis: Review of Literature and Case Report

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