Mitral Valve Infective Endocarditis after Trans-Catheter Aortic Valve Implantation
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Scarce data exist on mitral valve (MV) infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). This multicenter study included a total of 579 patients with a diagnosis of definite IE after TAVI from the IE after TAVI International Registry and aimed to evaluate the incidence, characteristics, management, and outcomes of MV-IE after TAVI. A total of 86 patients (14.9%) had MV-IE. These patients were compared with 284 patients (49.1%) with involvement of the transcatheter heart valve (THV) only. Two factors were found to be associated with MV-IE: the use of self-expanding valves (adjusted odds ratio 2.49, 95% confidence interval [CI] 1.23 to 5.07, p = 0.012), and the presence of an aortic regurgitation ≥2 at discharge (adjusted odds ratio 3.33; 95% CI 1.43 to 7.73, p <0.01). There were no differences in IE timing and causative microorganisms between groups, but surgical management was significantly lower in patients with MV-IE (6.0%, vs 21.6% in patients with THV-IE, p = 0.001). All-cause mortality rates at 2-year follow-up were high and similar between patients with MV-IE (51.4%, 95% CI 39.8 to 64.1) and patients with THV-IE (51.5%, 95% CI 45.4 to 58.0) (log-rank p = 0.295). The factors independently associated with increased mortality risk in patients with MV-IE were the occurrence of heart failure (adjusted p <0.001) and septic shock (adjusted p <0.01) during the index hospitalization. One of 6 IE episodes after TAVI is localized on the MV. The implantation of a self-expanding THV and the presence of an aortic regurgitation ≥2 at discharge were associated with MV-IE. Patients with MV-IE were rarely operated on and had a poor prognosis at 2-year follow-up.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | American Journal of Cardiology |
| Vol/bind | 172 |
| Sider (fra-til) | 90-97 |
| Antal sider | 8 |
| ISSN | 0002-9149 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
Dr. Rodés-Cabau holds the Research Chair "Fondation Famille Jacques Larivière" for the Development of Structural Heart Disease Interventions. Dr. Panagides has received a research grant from the “Mediterranean Academic Research and Studies in Cardiology” association (MARS Cardio). Funding: None
Funding Information:
Josep Rodés-Cabau has received institutional research grants from Edwards Lifesciences, Medtronic, and Boston Scientific. Vassili Panagides has received institutional research grants from Medtronic, Boston Scientific, and Microport. Didier Tchetche has reported consulting fees from Abbott Vascular, Boston Scientific, Edwards Lifesciences, and Medtronic. Howard C. Herrmann has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and consulting fees from Edwards Lifesciences and Medtronic. John G. Webb has reported that he has received consulting fees from Edwards Lifesciences and St. Jude Medical. Raj Makkar has reported that he has received research grants from Edwards Lifesciences, Medtronic, Abbott, Capricor Therapeutics, and St. Jude Medical; has served as a proctor for Edwards Lifesciences; and has received consulting fees from Medtronic. Fabio Sandoli de Brito Jr. has reported that he has received honoraria from Medtronic and Edwards Lifesciences for symposium speeches and proctoring cases. Stamatios Lerakis has reported that he has received consulting fees from Edwards Lifesciences. Hervé Le Breton reports lecture fees from Edwards Lifesciences, outside the submitted work. Jan Malte Sinning reports speaker honoraria from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and research grants from Boston Scientific, Edwards Lifesciences, and Medtronic, outside the submitted work. Kim Won-Keun reports personal fees from Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, and Meril, outside the submitted work. Stefan Stortecky reports grants to the institution from Edwards Lifesciences, Medtronic, Boston Scientific, and Abbott and personal fees from Boston Scientific, BTG, and Teleflex, outside the submitted work. Oliver Husser reports personal fees from Boston Scientific and payments from Abbott. Norman Mangner reports personal fees from Edwards Lifesciences, Medtronic, Biotronik, Novartis, Sanofi Genzyme, AstraZeneca, Pfizer, and Bayer, outside the submitted work. The other authors have no conflicts of interest to declare.
Publisher Copyright:
© 2022 Elsevier Inc.
ID: 313769798