Successful Treatment of Transcatheter Aortic Valve Replacement Infective Endocarditis Presenting With Aortic Root Abscess in an Immunocompromised Host

Gupta, Rahul; Ranchal, Purva; Raza, Anoshia; Sayed, Amer; Pattarkine, Rugved; Dhand, Abhay

doi:10.1097/mjt.0000000000001026

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Moreover, intubation, new pacemaker implantation, and CKD were risk factors for TAVI-IE (RR: 2.99, 95% CI 2.73 to 3.28; RR: 5.19, 95% CI 4.16 to 6.47; and RR: 1.17, 95% CI 1.05 to 1.29). Other variables showed no significant statistics and are presented in Table 2. A total of 51 articles which reported individual data of 157 patients were identified, 3 observational studies (Amat-Santos et al, 2015;Olsen et al, 2015;Rodriguez-Vidigal et al, 2018), 5 case series (Aung et al, 2013;Gallouche et al, 2018;Martinez-Selles et al, 2016;Puls et al, 2013;Scisło et al, 2019), 43 case reports (Ahmad et al, 2016;Campana et al, 2019;Carnero-Alcazar et al, 2010;Carrel and Eberle, 2019;Castiglioni et al, 2012;Cho et al, 2019;Chourdakis et al, 2017;Citro et al, 2013;Comoglio et al, 2009;Dapas et al, 2016;García-Pardo et al, 2012;Gonzalez et al, 2017;Gotzmann and Mugge, 2011;Gupta et al, 2019;Gürtler et al, 2019;Halapas et al, 2014;Head et al, 2011;Kesimci et al, 2014;Lane et al, 2015;Lee et al, 2014Lee et al, , 2019Loh et al, 2013;Loverix et al, 2013;Montero-Cruces et al, 2019;Mori et al, 2019;Morioka et al, 2019;Nguyen et al, 2019;Ochiai et al, 2016;Ohori et al, 2018;…”

Section: Resultsmentioning

confidence: 99%

Infective endocarditis after TAVI: a meta-analysis and systematic review of epidemiology, risk factors and clinical consequences

Tinică¹,

Tarus²,

Enache³

et al. 2020

Reviews in Cardiovascular Medicine

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Infective endocarditis (IE) represents one of the most challenging clinical entities, requiring a multidisciplinary approach. The increasing number of surgical and transcatheter heart valves replacements performed annually lead to a higher incidence of prosthetic valve endocarditis. Transcatheter aortic valve implantation (TAVI) brought a new alternative for the treatment of aortic stenosis and a new subgroup of IE with its features. We aimed to compare the incidence of IE in TAVI and surgical valve replacement (SAVR) to identify risk factors for TAVI-IE, evaluate the possible impact on mortality, and clarify the best treatment strategies. A digital scan in PubMed and SCOPUS databases was performed. 68 publications were selected to perform a meta-analysis and systematic review on epidemiology, risk factors, and mortality predictors in TAVI-IE. No significant difference in IE rate was noted between patients with TAVI and those with SAVR for in-hospital, early, mid-term and late IE. Male gender, intubation, new pacemaker implantation IE and CKD were correlated with TAVI-IE. Surgical treatment was performed in 22.3% of cases. Overall mortality for the pooled cohort was 38.3%. In a multivariate logistic regression model, surgical treatment and self-expandable device were linked to lower mortality in TAVI-IE. Even if the invasive procedure can trigger bacteremia, exposing the TAVI valve to future infection, no significant difference in IE rate was noted in our analysis between patients with TAVI and those with SAVR for in-hospital, early, mid-term and late IE. Surgical treatment of TAVI-IE can be a viable option in patients with a prohibitive risk score.

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Section: Resultsmentioning

confidence: 99%

Infective endocarditis after TAVI: a meta-analysis and systematic review of epidemiology, risk factors and clinical consequences

Tinică¹,

Tarus²,

Enache³

et al. 2020

Reviews in Cardiovascular Medicine

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Surgical treatment of transcatheter aortic valve infective endocarditis

et al. 2020

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There is growing interest in infections occurring after transcatheter aortic valve implantation (TAVI). The incidence, and clinical and anatomical features suggest many similarities with prosthetic valve endocarditis. The survival of patients with an infected TAVI prosthesis is generally poor; however, only a minority of them (10%) have undergone treatment with surgical explantation of the infected prosthesis. A literature search was performed using online databases. Papers reporting surgical treatment of TAVI prosthesis infections were retrieved, focusing on pre- and intraoperative characteristics and early outcome. Thirty-seven papers ultimately provided information on 107 patients. Their mean ± standard deviation (SD) age was 76 ± 8 years and 72% were male. The mean ± SD time interval between the TAVI procedure and reoperation was 10 ± 10 months. Annular abscess formation was described in 34% of cases and mitral valve involvement in 31%. All patients underwent TAVI prosthesis explantation and surgical aortic valve replacement; concomitant mitral valve replacement was necessary in 22% of cases. Postoperative in-hospital mortality was 28%. Surgical explantation of infected TAVI prostheses was associated with a high postoperative mortality, although these initial experiences included elderly and high-risk patients. Considering the expansion of TAVI procedures towards younger and lower-risk patients, surgical treatment of TAVI endocarditis may represent the best option for a life-saving procedure.

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Successful Treatment of Transcatheter Aortic Valve Replacement Infective Endocarditis Presenting With Aortic Root Abscess in an Immunocompromised Host

Cited by 2 publications

References 6 publications

Infective endocarditis after TAVI: a meta-analysis and systematic review of epidemiology, risk factors and clinical consequences

Infective endocarditis after TAVI: a meta-analysis and systematic review of epidemiology, risk factors and clinical consequences

Surgical treatment of transcatheter aortic valve infective endocarditis

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