Prosthetic valve endocarditis after transcatheter aortic valve replacement in low‐risk patients

Abstract

Objectives: We sought to report details of the incidence, organisms, clinical course, and outcomes of prosthetic valve endocarditis (PVE) after transcatheter aortic valve replacement (TAVR) in low-risk patients.Background: PVE remains a rare but devastating complication of aortic valve replacement. Data regarding PVE after TAVR in low-risk patients are lacking.Methods: We performed a detailed review of all patients in the low-risk TAVR trials who underwent TAVR from 2016 to 2020 and were adjudicated to have definitive PVE by the independent Clinical Events Committee.Results: We analyzed 396 low-risk patients who underwent TAVR (including 72 with bicuspid valves). PVE occurred in 11 patients at a median 379 days (210, 528) from

Infective Endocarditis Following Aortic Valve Replacement: A Systematic Review

“…According to one study, IE has significantly decreased throughout generations of balloon-expandable valves [ 12 ]. Still, Medranda et al’s study found that 100% of the patients who developed IE had a balloon-expandable SAPIEN 3 THV [ 25 ].…”

“…Del Val et al reported that etiological differences contribute to the time IE is diagnosed following TAVR and found that patients infected with S. aureus were diagnosed an average of 1.6 months before non- S. aureus -infected patients [ 24 ]. One analysis on TAVR studies showed the age at which a person tended to develop IE, and the average age of patients who developed IE was 77.25 years old between the studies [ 18 , 22 , 25 , 33 ].…”

“…It is essential to consider the overall AVR-associated IE’s etiology, and the most common routes of IE were recent dental work and recent invasive procedures [ 25 ]. The most common microorganisms observed to cause IE were S. aureus, Streptococcus , and Enterococcus spp ., with rates up to 30.4%, 29.9%, and 20.5%, respectively, and S. aureus is the most common cause [ 14 , 16 , 18 , 35 ].…”

“…Most studies found that the most common microorganism causing IE was Enterococcus , and it was usually followed by S. aureus , Streptococcus viridans , and coagulase-negative Staphylococci , especially in the peri-procedural period [ 15 , 18 , 19 , 22 , 23 , 27 - 29 , 32 ]. However, some studies observed Streptococcus as the most common microorganism, usually seen in IE stemming from dental procedures [ 13 , 21 , 25 , 26 , 29 , 31 ]. Two other studies observed that S. aureus was the most common microorganism causing IE [ 29 , 33 ].…”

“…The most common IE symptom was fever, seen on admissions, and other symptoms, such as chills, rigor, sweats, lethargy, malaise, and acute heart failure [ 19 , 23 - 25 , 32 ]. The majority of patients experienced complications during hospitalization, such as vegetation, regurgitations, abscess, neurological symptoms, systemic embolisms, renal failure, and uncontrolled infections, causing bacteremia and leading to severe sepsis and septic shock [ 18 , 19 , 21 - 23 , 25 , 27 , 29 , 34 ]. Vegetations occurred frequently and typically developed on the prosthetic leaflet with an average size of 10.7 mm [ 19 , 23 , 32 ].…”