Three-Dimensional Echocardiography for Diagnosis of Transcatheter Prosthetic Aortic Valve Endocarditis

Gonzalez, Yahaira Ortiz; Ung, Ryan; Blackshear, Joseph L.; Laman, Steven M.

doi:10.1016/j.case.2017.05.002

Cited by 4 publications

(6 citation statements)

References 10 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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“…In particular, 3D TEE imaging has proven to be critical for assessment of complex valvular pathologies, as well as guiding interventional procedures, such as the percutaneous mitral valve edgeto-edge repair (15)(16)(17)(18). The impact of contemporary TEE imaging on the diagnosis of IE and its subtypes has not been well studied (19,20). The reported sensitivity of TEE for IE has varied between 92% to 96%, and a second TEE is recommended if clinical suspicion remains high after a negative examination (21)(22)(23).…”

Section: Rationale and Knowledge Gapmentioning

confidence: 99%

“…The present study was performed to investigate the 34 [20] Dental procedure ‡ 5 [7] 12 [7] Other surgeries 8 [11] 25 [14] Congenital 2). Additionally, this may reflect the increased use of modern TEE probes with enhanced imaging capabilities during the index TEE in 2019 versus 2011 (72.9% versus 25.6%, respectively, P<0.001, Figure 2).…”

Section: Key Findingsmentioning

confidence: 99%

Diagnostic performance of contemporary transesophageal echocardiography with modern imaging for infective endocarditis

Montanè¹,

Chahine²,

Fiore³

et al. 2023

Cardiovasc Diagn Ther

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Background: Infective endocarditis (IE) is associated with high morbidity and mortality. Following an initial negative transesophageal echocardiogram (TEE), high clinical suspicion warrants repeat examination.We evaluated the diagnostic performance of contemporary TEE imaging for IE. Methods: This retrospective cohort study included patients ≥18 years old undergoing ≥2 TEEs within 6 months, with confirmed diagnosis of IE based on Duke criteria, 70 in 2011 and 172 in 2019, were included. We compared the diagnostic performance of TEE for IE in 2019 versus 2011. The primary endpoint was the sensitivity of initial TEE to detect IE. Results: Sensitivity of the initial TEE to detect endocarditis was 85.7% versus 95.3%, in 2011 and 2019, respectively (P=0.01). On multivariable analysis, initial TEE more frequently detected IE in 2019, compared to 2011 [odds ratio (OR): 4.06, 95% confidence intervals (CIs): 1.41-11.71, P=0.01]. Improved diagnostic performance was driven by improved detection of prosthetic valve infective endocarditis (PVIE), sensitivity 70.8% in 2011 versus 93.7% (P=0.009) in 2019. In 2019, TEEs more frequently utilized probes with higher frame rates/resolution, than 2011 (P<0.001). Three dimensional (3D) technology was utilized in 97.2% of initial TEEs in 2019, compared to 70.5% in 2011 (P<0.001).Conclusions: Contemporary TEE was associated with improved diagnostic performance for endocarditis, driven by improved sensitivity for PVIE.

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“…Recent research and case studies have shown the importance of 3D TOE in the detection of vegetations and abscesses 29–33 . The precise identification of vegetations and periannular extension in patients with IE associated with PV appears to be facilitated by the inclusion of 3D acquisitions, even in instances in which the diagnosis initially missed by 2D TOE 29,31 .…”

Section: Addition Of Conventional 3d Toe To 2d Toementioning

confidence: 99%

Novel 3D versus traditional transesophageal echocardiography techniques: Defining differences in the diagnosis of infective endocarditis

Tomoaia,

Beyer,

Dădârlat‐Pop

et al. 2023

Eur J Clin Investigation

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BackgroundDespite the availability of current antibiotic and surgical treatment options, infective endocarditis (IE) remains associated with a high mortality rate. Even though two‐dimensional (2D) transesophageal echocardiography (TOE) is a major criteria in the diagnosis of IE, it is constrained by the single‐plane orientation. Since three‐dimensional (3D) TOE provides a comprehensive understanding of the cardiac architecture by allowing for a realistic visualization of the underlying structures in 3D space, it has attracted considerable interest in recent years.AimThe purpose of this narrative review is to discuss the advantages and pitfalls of 3D TOE in patients with IE, as well as to address emerging photo‐realistic 3D techniques that have the potential to enhance the visualization of cardiac structures in this setting.ResultsAccording to recent research, 3D TOE acquisitions outperform 2D acquisitions in terms of vegetation identification accuracy and embolism risk assessment. By reporting a variety of findings that are missed with 2D TOE, but which are validated by surgical examination, 3D TOE further improves the ability to identify endocarditis complications on both native and prosthetic valves. In addition to conventional 3D TOE, future developments in 3D technology led to the development of transillumination and tissue‐transparency rendering, which may improve anatomical understanding and depth perception. Due to the use of both conventional and novel 3D techniques, there are more patients who require surgical intervention, indicating that 3D TOE may have a clinical relevance on the surgical management.Conclusion3D TOE might fill the gaps left by 2D TOE in the diagnosis of IE.

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Three-Dimensional Echocardiography for Diagnosis of Transcatheter Prosthetic Aortic Valve Endocarditis

Abstract: Graphical abstract

Cited by 4 publications

References 10 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

Diagnostic performance of contemporary transesophageal echocardiography with modern imaging for infective endocarditis

Novel 3D versus traditional transesophageal echocardiography techniques: Defining differences in the diagnosis of infective endocarditis

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